POPCORN 2

Question 1

A patient presents with diarrhea and abdominal cramping. The organism isolated from the stool culture is identified as S. dysenteriae (group A). The TSI reaction would have indicated:
A. K/K
B. K/NC H2S+
C. A/A
D. K/A

Answer 1

D. K/A

Question 2

Which organisms are plump coccobacilli that may resist decolorization and may be mistaken for Neisseria spp?
A. Acinetobacter spp.
B. Bordetella spp.
C. Stenotrophomonas sp.
D. Burkholderia sp.

Answer 2

A. Acinetobacter spp.

Question 3

Which organism has large, smooth, glistening colonies with a lavender pigment and smells like ammonia?
A. Acinetobacter spp.
B. Bordetella spp.
C. Stenotrophomonas sp.
D. Burkholderia sp.

Answer 3

C. Stenotrophomonas sp.

Question 4

All of the following agars may be used to isolate Helicobacter except:
A. Campy-CVA
B. Skirrow’s
C. Thiosulfate-citrate-bile salts-sucrose agar (TCBS)
D. modified Thayer-Martin

Answer 4

C. Thiosulfate-citrate-bile salts-sucrose agar (TCBS)

NOTE:
Stool specimens submitted for culture of H. cinaedi and H. fennelliae are inoculated onto selective media used for Campylobacter isolation but without cephalothin such as Campy-CVA.
For the recovery of H. pylori from tissue biopsy specimens including gastric antral biopsies, non-selective agar media, including chocolate agar and Brucella agar with 5% sheep blood, have resulted in successful recovery of the organisms.
Selective agar such as Skirrow’s and modified Thayer-Martin agar also support growth.

Question 5

Which of the following tests is most helpful in differentiating C.jejuni from the other Campylobacter spp.?
A. Nitrate reduction
B. Urease activity
C. Hippurate hydrolysis
D. Susceptibility to nalidixic acid

Answer 5

C. Hippurate hydrolysis

Question 6

A positive hippurate hydrolysis is a characteristic of:
A. Campylobacter coli
B. Campylobacter jejuni
C. Campylobacter lari
D. Campylobacter fetus

Answer 6

B. Campylobacter jejuni

Question 7

Which of the following has been recognized in postinfectious complications of a Campylobacter jejuni infection?
A. Guillain-Barré syndrome
B. Chronic pulmonary disease
C. Encephalitis
D. Endocarditis

Answer 7

A. Guillain-Barré syndrome

Question 8

A 60-year-old man suffered from fever, watery diarrhea, abdominal pain, and nausea. Three weeks later, he was admitted to the hospital unable to speak but coherent and oriented. Neurological examination revealed bilateral muscle weakness in his legs. Within hours, the muscle weakness extended to his arms and chest. He was diagnosed with Guillain–Barré syndrome. With which organism was he most likely infected?
A. Campylobacter jejuni
B. Clostridium tetani
C. Cytolmegalovirus
D. Salmonella enterica
E. Shigella sonnei

Answer 8

A. Campylobacter jejuni

Question 9

Which of the following organisms is coagulase positive?
A. S. saprophyticus
B. S. haemolyticus
C. S. hominis
D. S. pseudointermedius

Answer 9

D. S. pseudointermedius

Question 10

Which test is used for the determination of inducible clindamycin resistance in staphylococci and streptococci?
A. E-test
B. D-zone test
C. A-test
D. CAMP test

Answer 10

B. D-zone test

Question 11

The D-zone susceptibility test is used to test inducible resistance on S. aureus strains demonstrating an initial antibiotic susceptibility profile of:
A. Erythromycin sensitive, clindamycin sensitive
B. Erythromycin resistant, clindamycin sensitive
C. Erythromycin resistant, clindamycin resistant
D. Erythromycin sensitive, clindamycin resistant

Answer 11

B. Erythromycin resistant, clindamycin sensitive

Question 12

Resistance to clindamycin can be induced in vitro by
A. Ampicillin
B. Erythromycin
C. Gentamicin
D. Penicillin

Answer 12

B. Erythromycin

Question 13

Infection caused by non–acid-fast aerobic actinomycetes is usually chronic, granulomatous lesions of the skin referred to as:
A. Mycelium
B. Necrosis
C. Impetigo
D. Mycetoma

Answer 13

D. Mycetoma

Question 14

Which Nocardia sp. causes more than 80% of human infections?
A. N. asteroides
B. N. brasiliensis
C. N. otitidiscaviarum
D. N. farcina

Answer 14

A. N. asteroides

Question 15

Which of the following is the key pathogen that infects the lungs of patients with cystic fibrosis?
A. B. cepacia
B. B. pseudomallei
C. P. fluorescens
D. P. aeruginosa

Answer 15

D. P. aeruginosa

Question 16

The colonial appearance of this bacteria on BAP agar is gray, translucent, smooth, glistening colonies, which may also have a dry, claylike consistency:
A. Neisseria gonorrhoeae
B. Neisseria elongata
C. Moraxella catarrhalis
D. Moraxella osloensis

Answer 16

B. Neisseria elongata

Question 17

Large, nonpigmented or gray, opaque, smooth; friable “HOCKEY PUCK” consistency; colony may be moved intact over surface of CAP:
A. Neisseria gonorrhoeae
B. Neisseria meningitidis
C. Neisseria elongata
D. Moraxella catarrhalis

Answer 17

D. Moraxella catarrhalis

Question 18

Convex, smooth, gray, nonhemolytic; rough and mucoid variants can occur; may have a musty or mushroom odor:
A. Pseudomonas aeruginosa
B. Clostridium difficile
C. Pasteurella multocida
D. Chromobacterium violaceum

Answer 18

C. Pasteurella multocida

Question 19

Distinct odor that is often referred to as a “chocolate cake” or “burnt chocolate” smell:
A. Burkholderia cepacia
B. Eikenella corrodens
C. Proteus sp.
D. Staphylococcus aureus

Answer 19

C. Proteus sp.

Question 20

Which of the following conditions is viewed as a risk factor for systemic disease caused by Pasteurella multocida subsp. multocida?
A. Liver cirrhosis
B. End-stage renal disease
C. Hyperlipidemia
D. Hereditary hemochromatosis

Answer 20

A. Liver cirrhosis

Question 21

Which of the following Haemophilus species is an agent of a sexually transmitted disease?
A. H. parainfluenzae
B. H. influenzae
C. H. ducreyi
D. H. segnis

Answer 21

C. H. ducreyi

Question 22

Which encapsulated type of H. influenzae is most common?
A. Type a
B. Type b
C. Type c
D. Type d

Answer 22

B. Type b

Question 23

All of the following organisms require X and V factors, except:
A. H. influenzae
B. H. haemolyticus
C. H. influenzae biotype aegyptius
D. Aggregatibacter aphrophilus

Answer 23

D. Aggregatibacter aphrophilus

Question 24

Which of the following is an effective drug for treating chancroid?
A. Ampicillin
B. Erythromycin
C. Amoxicillin
D. Tetracycline

Answer 24

B. Erythromycin

Question 25

Bartonella quintana has been known to cause:
A. Carrion’s disease
B. Trench fever
C. Cat-scratch disease
D. Lyme disease

Answer 25

B. Trench fever

Question 26

Campylobacter are:
A. Small, curved, motile, gram-positive bacilli
B. Small, curved, motile gram-negative bacilli
C. Small, curved, nonmotile, gram-negative bacilli
D. Small, curved, nonmotile, gram-negative bacilli

Answer 26

B. Small, curved, motile gram-negative bacilli

Question 27

Campylobacter species should be grown at what optimum temperature?
A. 25° C
B. 37° C
C. 42° C
D. None of the above

Answer 27

C. 42° C

Question 28

Which of the following agars should be used for culturing Legionella?
A. CIN
B. BCYE
C. SMAC
D. XLD

Answer 28

B. BCYE

Question 29

What is the specimen of choice for culturing B. pertussis?
A. Throat
B. NP swab
C. Sputum
D. Anterior nose

Answer 29

B. NP swab

Question 30

The most reliable serologic test for diagnosis of B. pertussis in adults and adolescents is:
A. Complement fixation
B. Agglutination
C. Anti-PT ELISA (antibody to pertussis toxin)
D. EIA

Answer 30

C. Anti-PT ELISA (antibody to pertussis toxin)

Question 31

Optimal recovery of F. tularensis is acquired by:
A. Increased CO2
B. Enriched media containing cysteine
C. 24-hour growth at room temperature
D. Anaerobic conditions

Answer 31

B. Enriched media containing cysteine

Question 32

When S. moniliformis is acquired by ingestion, the disease is called:
A. Trench fever
B. Haverhill fever
C. Cat scratch disease
D. Lyme disease

Answer 32

B. Haverhill fever

Question 33

Spirillum minus also causes rat-bite fever in humans and is referred to as:
A. Haverhill fever
B. Legionnaire’s disease
C. Hantavirus
D. Sodoku

Answer 33

D. Sodoku

Question 34

The natural habitat of Streptobacillus moniliformis is the upper respiratory tract of:
A. African dwarf frogs
B. Wild and laboratory rats
C. Prairie rattlesnakes
D. Black-footed ferrets

Answer 34

B. Wild and laboratory rats

Question 35

Specimen characteristics of an anaerobic infection include:
A. Foul odor, presence of sulfur granules, and green fluorescence
B. Foul odor, presence of metachromatic granules, and green fluorescence
C. Foul odor, sulfur smell, and red fluorescence
D. Foul odor, presence of sulfur granules, and red fluorescence

Answer 35

D. Foul odor, presence of sulfur granules, and red fluorescence

NOTE:
Upon receipt in the laboratory, specimens should be inspected for characteristics that strongly indicate the presence of anaerobes:
1. Foul odor
2. Sulfur granules (associated with Actinomyces spp., Propionibacterium spp., or Eubacterium nodatum)
3. Brick red fluorescence under long wavelength ultraviolet (UV) light (associated with pigmented Prevotella or Porphyromonas spp).

Question 36

Sulfur granules in a clinical specimen indicate the presence of:
A. Clostridium spp.
B. Fusobacterium spp.
C. Actinomyces spp.
D. Peptostreptococcus spp.

Answer 36

C. Actinomyces spp.

Question 37

The ETHANOL SHOCK procedure is used to differentiate:
A. Actinomyces and Bifidobacterium spp.
B. Prevotella and Porphyromonas spp.
C. Clostridium and Bacteroides spp.
D. Bacteroides and Actinomyces spp.

Answer 37

C. Clostridium and Bacteroides spp.

Question 38

The unique chemical structure of the cell wall of Mycobacterium spp. is associated with the presence of:
A. N-glycolylmuramic acid and a decrease in lipid content
B. N-acetylmuramic acid and a decrease in lipid content
C. N-glycolylmuramic acid and an increase in lipid content
D. N-acetylmuramic acid and an increase in lipid content

Answer 38

C. N-glycolylmuramic acid and an increase in lipid content

Question 39

Which organism causes Rocky Mountain spotted fever?
A. Chlamydia trachomatis
B. Ehrlichia chaffeensis
C. Rickettsia rickettsii
D. Coxiella burnetii

Answer 39

C. Rickettsia rickettsii

Question 40

Which serovar of Chlamydia trachomatis causes lymphogranuloma venereum?
A. A
B. C
C. H
D. L1

Answer 40

D. L1

Question 41

Which of the following organisms is acquired via exposure to infected birds?
A. Coxiella burnetii
B. Chlamydia psittaci
C. Anaplasma phagocytophilum
D. Tropheryma whipplei

Answer 41

B. Chlamydia psittaci

Question 42

Transmission of Orientia tsutsugamushi is associated with what vector?
A. Ticks
B. Fleas
C. Lice
D. Chiggers

Answer 42

D. Chiggers

Question 43

Which fungus is most often acquired by traumatic implantation into the skin?
A. Histoplasma capsulatum
B. Sporothrix schenckii
C. Coccidioides immitis
D. Penicillium marneffei

Answer 43

B. Sporothrix schenckii

Question 44

What are the optimal temperature and incubation time before a FUNGAL blood culture is reported as negative?
A. 37°C; 21 days
B. 37°C; 7 days
C. 30°C; 21 days
D. 30°C; 7 days

Answer 44

C. 30°C; 21 days

Question 45

Which test can be used to differentiate T. mentagrophytes from T. rubrum?
A. Fluorescence using a Wood’s lamp
B. In vitro hair perforation
C. Red color on reverse side of colony
D. Pyriform microconidia

Answer 45

B. In vitro hair perforation

Question 46

Which dimorphic fungus may be contracted by people who clean chicken coops?
A. Blastomyces dermatitidis
B. Histoplasma capsulatum
C. Coccidioides immitis
D. Paracoccidioides brasiliensis

Answer 46

B. Histoplasma capsulatum

Question 47

Adding specimen scrapings to 10% KOH to show the presence of sclerotic bodies that resemble copper pennies is useful in the diagnosis of:
A. Chromoblastomycosis
B. Phaeohyphomycosis
C. Mycetomas
D. Zygomycosis

Answer 47

A. Chromoblastomycosis

Question 48

Which of the following is a fungus known to cause chromoblastomycosis?
A. Curvularia spp.
B. Acremonium spp.
C. Bipolaris spp.
D. Cladosporium spp.

Answer 48

D. Cladosporium spp.

Question 49

Germ tube formation is seen with which two yeasts?
A. C. albicans, C. neoformans
B. C. albicans, C. parapsilosis
C. C. glabrata, C. parapsilosis
D. C. albicans, C. dubliniensis
E. C. glabrata, C. dubliniensis

Answer 49

D. C. albicans, C. dubliniensis

Question 50

In the virus laboratory, most manipulation of viruses occurs at what safety level?
A. Biosafety Level 1
B. Biosafety Level 2
C. Biosafety Level 3
D. No biosafety is needed

Answer 50

B. Biosafety Level 2

Question 51

Which family of viruses produces one of the most lethal hemorrhagic fevers?
A. Bunyaviridae
B. Filoviridae
C. Flaviviridae
D. Arenaviridae

Answer 51

B. Filoviridae

Question 52

A pulmonary syndrome, referred to as hanta pulmonary syndrome, that often results in death is carried in the excreta of:
A. Bats
B. Cats
C. Mice
D. Birds

Answer 52

C. Mice

Question 53

The three respiratory agents most often responsible for causing croup in pediatric patients are:
A. Parainfluenza, RSV, and rhinovirus
B. Influenza A, RSV, and parainfluenza 3
C. Coronavirus, RSV, and rhinovirus
D. Parainfluenza, RSV, and metapneumovirus

Answer 53

D. Parainfluenza, RSV, and metapneumovirus

Question 54

TAPEWORM SCOLEX:

Spatulate, 3 × 1 mm; no rostellum or hooklets; has 2 shallow grooves (bothria)

Answer 54

Diphyllobothrium latum

Question 55

TAPEWORM SCOLEX:

Quadrate, 1-2 mm in diameter; no rostellum or hooklets; 4 suckers

Answer 55

Taenia saginata

Question 56

TAPEWORM SCOLEX:

Quadrate, 1-mm diameter; has rostellum and hooklets; 4 suckers

Answer 56

Taenia solium

Question 57

TAPEWORM SCOLEX:

0.2-0.5 mm in diameter; has conical/retractile rostellum armed with 4-7 rows of small hooklets; 4 suckers

Answer 57

Dipylidium caninum

Question 58

TAPEWORM SCOLEX:

Knoblike but not usually seen; has rostellum and hooklets; 4 suckers

Answer 58

Hymenolepis nana

Question 59

TAPEWORM SCOLEX:

Knoblike but not usually seen; has rostellum but no hooklets; 4 suckers

Answer 59

Hymenolepis diminuta

Question 60

The BAERMANN TECHNIQUE yields a good concentration of the living larvae of:
A. Angiostrongylus cantonensis
B. Brugia malayi
C. Enterobius vermicularis
D. Strongyloides stercoralis

Answer 60

D. Strongyloides stercoralis

Question 61

In which of the following sets of nematodes can each organism cause a pneumonia-like syndrome in a person exposed to heavy infection with any of the three parasites?
A. Ascaris lumbricoides, Trichuris trichiura, or Onchocerca volvulus
B. Enterobius vermicularis, Dracunculus medinensis, or Trichuris trichiura
C. Strongyloides stercoralis, Wuchereria bancrofti, or Angiostrongylus costaricensis
D. Necator americanus, Ascaris lumbricoides, or Strongyloides stercoralis

Answer 61

D. Necator americanus, Ascaris lumbricoides, or Strongyloides stercoralis

Question 62

Inhabits the small intestine and is usually demonstrated as rhabditiform larva (no eggs usually seen) in stool sample:
A. Hookworm
B. Trichuris trichiura
C. Ascaris lumbricoides
D. Strongyloides stercoralis

Answer 62

D. Strongyloides stercoralis

Question 63

Which parasite causes eosinophilic meningoencephalitis, a form of larva migrans causing fever, headache, stiff neck, and increased cells in the spinal fluid?
A. Necator americanus
B. Angiostrongylus cantonensis
C. Ancylostoma braziliense
D. Strongyloides stercoralis

Answer 63

B. Angiostrongylus cantonensis

Question 64

Symptoms and signs mimic those of TUBERCULOSIS, and should always be suspected in patients with tuberculosis who are non-responsive to treatment:
A. Ascaris lumbricoides
B. Necator americanus
C. Strongyloides stercoralis
D. Paragonimus westermani

Answer 64

D. Paragonimus westermani

Question 65

Finely granular, “ground glass” appearance; clear differentiation of ectoplasm and endoplasm; if present, vacuoles are usually small; RBCs not present in cytoplasm
A. Endolimax nana
B. Entamoeba coli
C. Entamoeba dispar
D. Entamoeba histolytica

Answer 65

C. Entamoeba dispar

Question 66

Finely granular, “ground glass” appearance; clear differentiation of ectoplasm and endoplasm; if present, vacuoles are usually small; presence of red blood cells (RBCs) is diagnostic
A. Endolimax nana
B. Entamoeba coli
C. Entamoeba dispar
D. Entamoeba histolytica

Answer 66

D. Entamoeba histolytica

Question 67

Entamoeba dispar is most easily confused morphologically with:
A. Entamoeba coli
B. Entamoeba hartmanni
C. Dientamoeba fragilis
D. Entamoeba histolytica
E. Blastocystis hominis

Answer 67

D. Entamoeba histolytica

Question 68

Early ring stages of the fifth human malaria, Plasmodium knowlesi, resemble those of:
A. Plasmodium malariae
B. Plasmodium ovale
C. Plasmodium falciparum
D. Plasmodium vivax

Answer 68

C. Plasmodium falciparum

Question 69

Older developing stages (trophs, schizonts) of the fifth human malaria, P. knowlesi, resemble those of:
A. Plasmodium malariae
B. Plasmodium ovale
C. Plasmodium falciparum
D. Plasmodium vivax

Answer 69

A. Plasmodium malariae

Question 70

Synchronized rupture of RBCs every 72 hours:
A. P. falciparum
B. P. vivax
C. P. ovale
D. P. malariae

Answer 70

D. P. malariae

Question 71

Which species of Plasmodium may readily be identified when crescent-shaped gametocytes are found in stained blood films?
A. P. falciparum
B. P.malariae
C. P.ovale
D. P.vivax

Answer 71

A. P. falciparum

Question 72

Which species of malaria parasite usually has ameboid trophozoites and produces small reddish dots in the red blood cell cytoplasm?
A. Plasmodium knowlesi
B. Plasmodium falciparum
C. Plasmodium malariae
D. Plasmodium vivax

Answer 72

D. Plasmodium vivax

Question 73

Trophozoite tends to form “BANDS” across the cell:
A. P. vivax
B. P. malariae
C. P. falciparum
D. P. ovale

Answer 73

B. P. malariae

Question 74

Quadrate scolex with 4 suckers; no rostellum or hooklets:
A. D. latum
B. T. saginata
C. T. solium
D. H. diminuta

Answer 74

B. T. saginata

Question 75

Quadrate scolex with 4 suckers; has rostellum and hooklets:
A. D. latum
B. T. saginata
C. T. solium
D. H. diminuta

Answer 75

C. T. solium

Question 76

Proglottids with 15 to 20 lateral branches in dichotomous or tree-like arrangement:
A. D. latum
B. T. saginata
C. T. solium
D. D. caninum

Answer 76

B. T. saginata

Question 77

Proglottids with 7 to 13 lateral branches in a dendritic or finger-like arrangement:
A. D. latum
B. T. saginata
C. T. solium
D. D. caninum

Answer 77

C. T. solium

Question 78

A primary differential feature between Hymenolepis nana egg and H. diminuta egg is which of the following?
A. A flattened side for H. diminuta egg
B. A thick shell for H. nana egg
C. Polar filaments in H. nana egg
D. Radial striations in H. diminuta egg

Answer 78

C. Polar filaments in H. nana egg

Question 79

Fluke(s) associated with CHOLECYSTITIS (inflammation of the gallbladder), and CHOLANGIOCARCINOMA (cancerous growth in bile duct epithelium):
A. F. buski
B. P. westermani
C. C. sinensis, O. viverrini
D. S. japonicum

Answer 79

C. C. sinensis, O. viverrini

Question 80

The organism is transmitted through a bite of the tabinid fly or deer fly of the genus Chrysops.
A. B. malayi
B. L. loa
C. O. volvulus
D. W. bancrofti

Answer 80

B. L. loa

Question 81

The parasite is transmitted by the black fly, Simulium spp.
A. B. malayi
B. L. loa
C. O. volvulus
D. W. bancrofti

Answer 81

C. O. volvulus

Question 82

It resembles egg of S. haematobium, but acid-fast positive:
A. Schistosoma japonicum
B. Schistosoma mansoni
C. Schistosoma intercalatum
D. Schistosoma mekongi

Answer 82

C. Schistosoma intercalatum

Question 83

It causes alveolar hydatid disease which is the most lethal of all helminthic diseases:
A. Taenia saginata
B. Taenia solium
C. Echinococcus granulosus
D. Echinococcus multilocularis

Answer 83

D. Echinococcus multilocularis

Question 84

Intermediate host of Echinococcus multilocularis:
A. Dogs
B. Foxes
C. Coyotes
D. Rodents

Answer 84

D. Rodents

Question 85

Infection may resemble acute appendicitis:
A. Parastrongylus costaricensis
B. Gnathostoma sp.
C. Toxocara cati
D. Parastrongylus caninum

Answer 85

A. Parastrongylus costaricensis

Question 86

The intestinal nematode considered capable of vertical transmission and the potential cause for congenital infections is:
A. Ascaris lumbricoides
B. Enterobius vermicularis
C. Trichuris trichiura
D. Ancylostoma duodenale

Answer 86

D. Ancylostoma duodenale

Question 87

The principle most commonly used to measure the concentration of a particular analyte in the CHEMICAL examination of urine is:
A. Reflectance photometry
B. Digital imaging
C. Flow cytometry
D. Auto particle recognition

Answer 87

A. Reflectance photometry

Question 88

In automated urinalysis, the specific gravity is measured by:
A. Light transmittance
B. Light scattering
C. Refractometry
D. Turbidity

Answer 88

C. Refractometry

Question 89

All of the following are true concerning fully automated urine chemistry analyzers, except:
A. They are designed for a high-volume urinalysis laboratory
B. The reagent strip is dipped into the well-mixed urine
C. The urine moves through the instrument
D. A sample probe aspirates the urine

Answer 89

B. The reagent strip is dipped into the well-mixed urine

Question 90

The advantages of an automated urine microscopy analyzer over manual microscopy includes:
A. Cost-effective
B. Centrifugation not required
C. Standardized results
D. All of the above

Answer 90

D. All of the above

Question 91

Which of the following is a complete urinalysis automated urinalysis system?
A. AUTION ELEVEN AE 4022
B. Clinitek Atlas
C. iQ200 Automated Urine Microscopy
D. Clinitek AUWi Pro System

Answer 91

D. Clinitek AUWi Pro System

Question 92

What two technologies are used for urine sediment analysis?
A. Light scattering and refractometry
B. Light scattering and flow cytometry
C. Flow cytometry and digital imaging
D. Digital imaging and refractometry

Answer 92

C. Flow cytometry and digital imaging

Question 93

Which automated urine particle counter combines urine flow cytometry with digital image analysis?
A. UN-2000
B. iRICELL
C. UF-100i
D. iQ 200

Answer 93

A. UN-2000

Question 94

Which of the following urine sediment particles cannot be autovalidated but will be flagged and must be reviewed by laboratory personnel?
A. RBCs
B. WBCs
C. RTEs
D. Squamous epithelial cells

Answer 94

C. RTEs

Question 95

Which of the automated body fluid analyzers does not need to dilute or pretreat body fluids before analysis?
A. ADVIA 2120i
B. XN Series
C. iQ200
D. None of the above

Answer 95

B. XN Series

Question 96

What is a disadvantage of counting body fluid cells using an automated instrument versus a Neubauer hemocytometer?
A. Less labor-intensive and time-consuming
B. More precise
C. Unable to count low WBC numbers and malignant cells
D. Able to perform a WBC differential

Answer 96

C. Unable to count low WBC numbers and malignant cells

Question 97

The ultimate goal of a quality assessment program is to
A. maximize the productivity of the laboratory.
B. ensure that patient test results are precise.
C. ensure appropriate diagnosis and treatment of patients.
D. ensure the validity of laboratory results obtained.

Answer 97

D. ensure the validity of laboratory results obtained.

Question 98

Which of the following is a postanalytical component of a QA program?
A. Critical values
B. Procedures
C. Preventive maintenance
D. Test utilization

Answer 98

A. Critical values

Question 99

Analytical components of a QA program are procedures and policies that affect the
A. technical testing of the specimen.
B. collection and processing of the specimen.
C. reporting and interpretation of results.
D. diagnosis and treatment of the patient.

Answer 99

A. technical testing of the specimen.

Question 100

The purpose of quality control materials is to
A. monitor instrumentation to eliminate downtime.
B. ensure the quality of test results obtained.
C. assess the accuracy and precision of a method.
D. monitor the technical competence of laboratory staff.

Answer 100

C. assess the accuracy and precision of a method.

Question 101

Why are written procedures necessary?
A. To assist in the ordering of reagents and supplies for a
B. To appropriately monitor the accuracy and precision of a procedure
C. To ensure that all individuals perform the same task consistently
D. To ensure that the appropriate test has been ordered

Answer 101

C. To ensure that all individuals perform the same task consistently

Question 102

Which of the following is not considered to be an analytical component of QA?
A. Reagents (e.g., water)
B. Glassware (e.g., pipettes)
C. Instrumentation (e.g., microscope)
D. Specimen preservation (e.g., refrigeration)

Answer 102

D. Specimen preservation (e.g., refrigeration)

Question 103

Which of the following sources should include a protocol for the way to proceed when quality control results exceed acceptable tolerance limits?
A. A reference book
B. A procedure
C. A preventive maintenance manual
D. A specimen-processing protocol

Answer 103

B. A procedure

Question 104

Technical competence is displayed when a laboratory practitioner
A. documents reports in a legible manner.
B. recognizes discrepant test results.
C. independently reduces the time needed to perform a procedure (e.g., by decreasing incubation times).
D. is punctual and timely

Answer 104

B. recognizes discrepant test results.

Question 105

Quality control materials should have
A. a short expiration date.
B. a matrix similar to patient samples.
C. their values assigned by an external and unbiased commercial manufacturer.
D. the ability to test preanalytical variables.

Answer 105

B. a matrix similar to patient samples.

Question 106

Within one facility, what is the purpose of performing duplicate testing of a specimen by two different laboratories (i.e., in-house duplicates)?
A. It provides little information because the results are already known.
B. It saves money by avoiding the need for internal quality control materials.
C. It provides a means of evaluating the precision of a method.
D. It can detect procedural and technical differences among laboratories

Answer 106

D. It can detect procedural and technical differences among laboratories

Question 107

Interlaboratory comparison testing as with proficiency surveys provides a means to
A. identify critical values for timely reporting to clinicians.
B. ensure that appropriate documentation is being performed.
C. evaluate the technical performance of individual laboratory practitioners.
D. evaluate the performance of a laboratory compared with that of other laboratories.

Answer 107

D. evaluate the performance of a laboratory compared with that of other laboratories.

Question 108

The primary purpose of a Standard Precautions policy in the laboratory is to
A. ensure a safe and healthy working environment.
B. identify processes (e.g., autoclaving) to be used to neutralize infectious agents.
C. prevent the exposure and transmission of potentially infectious agents to others.
D. identify patients with hepatitis B virus, human immunodeficiency virus, and other infectious diseases.

Answer 108

C. prevent the exposure and transmission of potentially infectious agents to others.

Question 109

Which agency is responsible for defining, establishing, and monitoring safety and health hazards in the workplace?
A. Occupational Safety and Health Administration
B. Centers for Disease Control and Prevention
C. Chemical Hygiene Agency
D. National Fire Protection Association

Answer 109

A. Occupational Safety and Health Administration

Question 110

Which of the following is not considered personal protective equipment?
A. Gloves
B. Lab coat
C. Disinfectants
D. Goggles

Answer 110

C. Disinfectants

Question 111

Which of the following actions represents a good laboratory practice?
A. Washing or sanitizing hands frequently
B. Wearing lab coats outside the laboratory
C. Removing lab coats from the laboratory for laundering at home in 2% bleach
D. Wearing the same gloves to perform venipuncture on two different patients because the patients are in the same room

Answer 111

A. Washing or sanitizing hands frequently

Question 112

Which of the following is not an acceptable disposal practice?
A. Discarding urine into a sink
B. Disposing of used, empty urine containers with nonhazardous waste
C. Discarding a used, broken specimen transfer pipette with noninfectious glass waste
D. Discarding blood specimens into a biohazard container

Answer 112

C. Discarding a used, broken specimen transfer pipette with noninfectious glass waste

Question 113

Which of the following is not part of a Chemical Hygiene Plan?
A. To identify and label hazardous chemicals
B. To educate employees about the chemicals they use (e.g., providing material safety data sheets)
C. To provide guidelines for the handling and use of each chemical type
D. To monitor the handling of biological hazards

Answer 113

D. To monitor the handling of biological hazards

Question 114

Which of the following information is not found on a safety data sheet (SDS)?
A. Exposure limits
B. Catalog number
C. Hazardous ingredients
D. Flammability of the chemical

Answer 114

B. Catalog number

Question 115

Which of the following is the urine specimen of choice for cytology studies?
A. First morning specimen
B. Random specimen
C. Midstream “clean catch” collection
D. Timed collection

Answer 115

B. Random specimen

Question 116

Which of the following specimens usually eliminates contamination of the urine with entities from the external genitalia and the distal urethra?
A. First morning specimen
B. Midstream “clean catch” specimen
C. Random specimen
D. 4-hour timed collection

Answer 116

B. Midstream “clean catch” specimen

Question 117

Substances that show diurnal variation in their urinary excretion pattern are best evaluated using a
A. first morning specimen.
B. midstream “clean catch” specimen.
C. random specimen.
D. timed collection.

Answer 117

D. timed collection.

Question 118

Which of the following will not cause erroneous results in a 24-hour timed urine collection?
A. The collection starts and ends in the evening.
B. Two first morning specimens are included in the collection.
C. Multiple collection containers are not mixed together before specimen testing.
D. A portion of the collection is removed before total volume measurement.

Answer 118

A. The collection starts and ends in the evening.

Question 119

A 25-year-old woman complains of painful urination and is suspected of having a urinary tract infection. Which of the following specimens should be collected for a routine urinalysis and urine culture?
A. First morning specimen
B. Timed collection
C. Midstream “clean catch” specimen
D. Random specimen

Answer 119

C. Midstream “clean catch” specimen

Question 120

An unpreserved urine specimen collected at midnight is kept at room temperature until the morning hospital shift. Which of the following changes will most likely occur?
A. Decrease in urine color and clarity
B. Decrease in pH and specific gravity
C. Decrease in glucose and ketones
D. Decrease in bacteria and nitrite

Answer 120

C. Decrease in glucose and ketones

Question 121

Which of the following is the most common method used to preserve urine specimens?
A. Acid addition
B. Thymol addition
C. Freezing
D. Refrigeration

Answer 121

D. Refrigeration

Question 122

If refrigeration is used to preserve a urine specimen, which of the following may occur?
A. Cellular or bacterial glycolysis will be enhanced.
B. Formed elements will be destroyed.
C. Amorphous crystals may precipitate.
D. Bacteria will proliferate.

Answer 122

C. Amorphous crystals may precipitate.

Question 123

Which of the following urine preservatives is acceptable for both urinalysis and urine culture?
A. Boric acid
B. Chlorhexidine
C. Dowicil 200
D. Formalin

Answer 123

A. Boric acid

Question 124

How much urine is usually required for a manually performed routine urinalysis?
A. 5 to 10 mL
B. 10 to 15 mL
C. 20 to 30 mL
D. 50 to 100 mL

Answer 124

B. 10 to 15 mL

Question 125

Which of the following substances is higher in urine than in any other body fluid?
A. Chloride
B. Creatinine
C. Glucose
D. Protein

Answer 125

B. Creatinine

Question 126

How many nephrons are found in the average kidney?
A. 13,000
B. 130,000
C. 1.3 million
D. 13 million

Answer 126

C. 1.3 million

Question 127

Ultrafiltration of plasma occurs in glomeruli located in the renal
A. cortex.
B. medulla.
C. pelvis.
D. ureter.

Answer 127

A. cortex.

Question 128

Formation of the ultrafiltrate in the glomerulus is driven by the
A. hydrostatic blood pressure.
B. oncotic pressure of the plasma proteins.
C. osmotic pressure of the solutes in the ultrafiltrate.
D. pressures exerted by the glomerular filtration barrier.

Answer 128

A. hydrostatic blood pressure.

Question 129

Which of the following is a characteristic of renin, an enzyme secreted by specialized cells of the juxtaglomerular apparatus?
A. Renin stimulates the diffusion of urea into the renal interstitium.
B. Renin inhibits the reabsorption of sodium and water in the nephron.
C. Renin regulates the osmotic reabsorption of water by the collecting tubules.
D. Renin causes the formation of angiotensin and the secretion of aldosterone.

Answer 129

D. Renin causes the formation of angiotensin and the secretion of aldosterone.

Question 130

The kidneys play an important role in the
1. excretion of waste products.
2. regulation of water and electrolytes.
3. maintenance of acid-base equilibrium.
4. control of blood pressure and fluid balance.

A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

Answer 130

D. All are correct.

Question 131

What percent of the original ultrafiltrate formed in the urinary space actually is excreted as urine?
A. 1%
B. 10%
C. 25%
D. 33%

Answer 131

A. 1%

NOTE:
The fact that only 1% (approximately 1200 mL) of the original plasma ultrafiltrate presented to the renal tubules is excreted as urine is evidence of the large amount of reabsorption that takes place within the renal tubules.

Question 132

Substances bound to plasma proteins in the blood can be eliminated in the urine by
A. glomerular secretion.
B. glomerular filtration.
C. tubular secretion.
D. tubular reabsorption.

Answer 132

C. tubular secretion.

Question 133

The renal threshold level for glucose is 160 to 180 mg/dL. This corresponds to the
A. rate of glucose reabsorption by the renal tubules.
B. concentration of glucose in the tubular lumen fluid.
C. plasma concentration above which tubular reabsorption of glucose occurs
D. plasma concentration above which glucose is excreted in urine

Answer 133

D. plasma concentration above which glucose is excreted in urine

Question 134

More than 66% of filtered water, sodium, and chloride and 100% of filtered glucose, amino acids, and proteins are reabsorbed in the
A. collecting tubules.
B. distal tubules.
C. loops of Henle.
D. proximal tubules

Answer 134

D. proximal tubules

Question 135

Water reabsorption occurs throughout the nephron except in the
A. cortical collecting tubules.
B. proximal convoluted tubules.
C. ascending limb of the loops of Henle.
D. descending limb of the loops of Henle

Answer 135

C. ascending limb of the loops of Henle.

Question 136

Antidiuretic hormone regulates the reabsorption of
A. water in the collecting tubules.
B. sodium in the collecting tubules.
C. sodium in the distal convoluted tubule.
D. water and sodium in the loop of Henle

Answer 136

A. water in the collecting tubules.

Question 137

The final concentration of the urine is determined within the
A. collecting ducts.
B. distal convoluted tubules.
C. loops of Henle.
D. proximal convoluted tubules.

Answer 137

A. collecting ducts.

Question 138

Which of the following solutes are present in the largest molar amounts in urine?
A. Urea, chloride, and sodium
B. Urea, creatinine, and sodium
C. Creatinine, uric acid, and ammonium
D. Urea, uric acid, and ammonium

Answer 138

A. Urea, chloride, and sodium

Question 139

Renal excretion is NOT involved in the elimination of
A. electrolytes and water.
B. normal byproducts of fat metabolism.
C. soluble metabolic wastes (e.g., urea, creatinine).
D. exogenous substances (e.g., drugs, x-ray contrast media).

Answer 139

B. normal byproducts of fat metabolism.

Question 140

The concentration of which substances provides the best means of distinguishing urine from other body fluids?
A. Creatinine and urea
B. Glucose and protein
C. Uric acid and ammonia
D. Water and electrolytes

Answer 140

A. Creatinine and urea

Question 141

What is the definition of the osmolality of a solution?
A. The density of solute particles per liter of solvent
B. The mass of solute particles per kilogram of solvent
C. The number of solute particles per kilogram of solvent
D. The weight of solute particles per liter of solvent

Answer 141

C. The number of solute particles per kilogram of solvent

Question 142

Serum osmolality remains relatively constant, whereas the urine osmolality ranges from
A. one-third to one-half that of serum.
B. one-third to equal that of serum.
C. one to three times that of serum.
D. three to five times that of serum.

Answer 142

C. one to three times that of serum.

Question 143

Another name for excessive thirst is
A. polydipsia.
B. polyuria.
C. hydrophilia.
D. hydrostasis.

Answer 143

A. polydipsia.

Question 144

Specific gravity measurements are not affected by
A. temperature.
B. solute charge.
C. solute mass.
D. solute number.

Answer 144

B. solute charge.

Question 145

Osmolality is a measure of solute
A. density.
B. mass.
C. number.
D. weight.

Answer 145

C. number.

Question 146

Which of the following solutes, if added to pure water, affects the specific gravity of the resultant solution more than it affects its osmolality?
A. Sodium
B. Chloride
C. Potassium
D. Glucose

Answer 146

D. Glucose

Question 147

Occasionally the specific gravity of a urine specimen exceeds that physiologically possible (i.e., >1.040). Which of the following substances when found in urine could account for such a high value?
A. Creatinine
B. Glucose
C. Mannitol
D. Protein

Answer 147

C. Mannitol

Question 148

The excretion of large volumes of urine (>3 L/day) is called
A. glucosuria.
B. hyperuria.
C. polydipsia.
D. polyuria.

Answer 148

D. polyuria.

Question 149

The daily volume of urine excreted normally ranges from
A. 100 to 500 mL/day.
B. 100 to 1800 mL/day.
C. 500 to 1800 mL/day.
D. 1000 to 3000 mL/day.

Answer 149

C. 500 to 1800 mL/day.

NOTE:
Strasinger: Normal daily urine output is usually 1200 to 1500 mL, a range of 600 to 2000 mL is considered normal.

Question 150

When the body is dehydrated, the kidneys
A. excrete excess solutes in a constant volume of urine.
B. excrete solutes in as small a volume of urine as possible.
C. decrease the quantity of solutes excreted and decrease the urine volume.
D. increase the quantity of solutes excreted while holding the urine volume constant.

Answer 150

B. excrete solutes in as small a volume of urine as possible.

Question 151

The excretion of less than 400 mL of urine per day is called
A. anuria.
B. hypouria.
C. nocturia.
D. oliguria.

Answer 151

D. oliguria.

Question 152

The ultrafiltrate in the urinary space of the glomerulus has a specific gravity of
A. 1.005 and a lower osmolality than the blood plasma.
B. 1.010 and the same osmolality as the blood plasma.
C. 1.015 and a higher osmolality than the blood plasma.
D. 1.035 and a higher osmolality than the blood plasma.

Answer 152

B. 1.010 and the same osmolality as the blood plasma.

Question 153

All of the following conditions may produce nocturia except
A. anuria.
B. pregnancy.
C. chronic renal disease.
D. fluid intake at night.

Answer 153

A. anuria.

Question 154

Which renal function is assessed using specific gravity and osmolality measurements?
A. Concentrating ability
B. Glomerular filtration ability
C. Tubular excretion ability
D. Tubular secretion ability

Answer 154

A. Concentrating ability

Question 155

A fluid deprivation test is used to
A. determine renal plasma flow.
B. investigate the cause of oliguria.
C. assess renal concentrating ability.
D. measure the glomerular filtration rate.

Answer 155

C. assess renal concentrating ability.

Question 156

The volume of plasma cleared per minute in excess of that required for solute elimination is called the
A. creatinine clearance.
B. free-water clearance.
C. osmolar clearance.
D. renal clearance.

Answer 156

B. free-water clearance.

Question 157

Which of the following is an endogenous substance used to measure glomerular filtration rate?
A. Urea
B. Inulin
C. Creatinine
D. p-aminohippurate

Answer 157

C. Creatinine

Question 158

Creatinine is a good substance to use for a renal clearance test because it
A. is exogenous.
B. is reabsorbed.
C. is affected by fluid intake.
D. has a constant plasma concentration

Answer 158

D. has a constant plasma concentration

Question 159

Which of the following groups would be expected to have the greatest 24-hour excretion of creatinine?
A. Infants
B. Children
C. Women
D. Men

Answer 159

D. Men

Question 160

Creatinine clearance results are “normalized” using an individual’s body surface area to account for variations in the individual’s
A. age.
B. sex.
C. dietary intake.
D. muscle mass.

Answer 160

D. muscle mass.

Question 161

A 24-hour urine collection is preferred for determination of creatinine clearance because of diurnal variation in the
A. glomerular filtration rate.
B. plasma creatinine.
C. creatinine excretion.
D. urine excretion.

Answer 161

A. glomerular filtration rate.

Question 162

What percentage of the total cardiac output is received by the kidneys?
A. 8%
B. 15%
C. 25%
D. 33%

Answer 162

C. 25%

Question 163

The color of normal urine is due to the pigment
A. bilirubin.
B. urobilin.
C. uroerythrin.
D. urochrome

Answer 163

D. urochrome

Question 164

Which of the following urine characteristics provides the best rough indicator of urine concentration and body hydration?
A. Color
B. Clarity
C. Foam
D. Volume

Answer 164

A. Color

NOTE:
Because urochrome is excreted at a constant rate, the intensity of the yellow color in a fresh urine specimen can give a rough estimate of urine concentration. A dilute urine will be pale yellow and a concentrated specimen will be dark yellow.

Question 165

Which of the following pigments deposits on urate and uric acid crystals to form a precipitate described as “brick dust”?
A. Bilirubin
B. Urobilin
C. Uroerythrin
D. Urochrome

Answer 165

C. Uroerythrin

Question 166

Which of the following criteria should one use to consistently evaluate urine color and clarity?
1. Mix all specimens well.
2. Use the same depth or volume of a specimen.
3. Evaluate the specimens at the same temperature.
4. View the specimens against a dark background with good lighting.

A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

Answer 166

A. 1, 2, and 3 are correct.

Question 167

Select the urine specimen that does NOT indicate the possible presence of blood or hemoglobin.
A. Clear, red urine
B. Cloudy, brown urine
C. Clear, brown urine
D. Cloudy, amber urine

Answer 167

D. Cloudy, amber urine

Question 168

A urine that produces a large amount of white foam when mixed should be suspected to contain increased amounts of
A. bilirubin.
B. protein.
C. urobilin.
D. urobilinogen.

Answer 168

B. protein.

Question 169

Which of the following substances can change the color of a urine and its foam?
A. Bilirubin
B. Hemoglobin
C. Myoglobin
D. Urobilin

Answer 169

A. Bilirubin

Question 170

The clarity of a well-mixed urine specimen that has visible particulate matter and through which newsprint can be seen but not read should be described as
A. cloudy.
B. flocculated.
C. slightly cloudy.
D. turbid.

Answer 170

A. cloudy.

Question 171

Which of the following urine specimens is considered normal?
A. A freshly voided urine that is brown and clear
B. A freshly voided urine that is yellow and cloudy
C. A clear yellow urine specimen that changes color upon standing
D. A clear yellow urine specimen that becomes cloudy upon refrigeration

Answer 171

D. A clear yellow urine specimen that becomes cloudy upon refrigeration

Question 172

A white or beige precipitate in a “normal” alkaline urine most likely is caused by
A. amorphous phosphates.
B. amorphous urates.
C. uric acid crystals.
D. radiographic contrast media.

Answer 172

A. amorphous phosphates.

Question 173

Which of the following methods used to determine the specific gravity of urine does NOT detect the presence of urine protein or glucose?
A. Harmonic oscillation densitometry
B. Reagent strip
C. Refractometry
D. Urinometry

Answer 173

B. Reagent strip

Question 174

Which of the following specific gravity values is physiologically impossible?
A. 1.000
B. 1.010
C. 1.020
D. 1.030

Answer 174

A. 1.000

Question 175

Which of the following methods is an indirect measure of specific gravity?
1. Reagent strip
2. Urinometry
3. Refractometry
4. Harmonic oscillation densitometry

A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

Answer 175

B. 1 and 3 are correct.

Question 176

The principle of the reagent strip method for measuring specific gravity is based on
A. the pKa of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen.
B. the pH of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen.
C. the pKa of a polyelectrolyte increasing in proportion to the ionic concentration of the specimen.
D. the pH of a polyelectrolyte increasing in proportion to the ionic concentration of the specimen.

Answer 176

A. the pKa of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen.

Question 177

Which of the following as described is NOT a colligative property?
A. Boiling point elevation
B. Freezing point depression
C. Osmotic pressure depression
D. Vapor pressure depression

Answer 177

C. Osmotic pressure depression

Question 178

Which of the following will not influence the volume of urine produced?
A. Diarrhea
B. Exercise
C. Caffeine ingestion
D. Carbohydrate ingestion

Answer 178

D. Carbohydrate ingestion

Question 179

To preserve the integrity of reagent strips, it is necessary that they are
A. humidified adequately.
B. stored in a refrigerator.
C. stored in a tightly capped container.
D. protected from the dark.

Answer 179

C. stored in a tightly capped container.

Question 180

Using quality control materials, one should check reagent strip performance
1. at least once daily.
2. when a new bottle of strips or tablets is opened.
3. when a new lot number of strips or tablets is placed into use.
4. once each shift by each laboratorian performing urinalysis testing.

A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

Answer 180

A. 1, 2, and 3 are correct.

Question 181

Which of the following is not checked by quality control materials?
A. The technical skills of the personnel performing the test
B. The integrity of the specimen, that is, that the specimen was collected and stored properly
C. The test protocol, that is, that the procedure was performed according to written guidelines
D. The functioning of the equipment used—for example, the refractometer and the reagent strip readers

Answer 181

B. The integrity of the specimen, that is, that the specimen was collected and stored properly

Question 182

Quality control materials used to assess the performance of reagent strips and tablet tests must
A. be purchased from a commercial manufacturer.
B. yield the same results regardless of the commercial brand used.
C. contain chemical constituents at realistic and critical detection levels.
D. include constituents to assess the chemical and microscopic examinations.

Answer 182

C. contain chemical constituents at realistic and critical detection levels.

Question 183

Which of the following is NOT a source of erroneous results when reagent strips are used?
A. Testing a refrigerated urine specimen
B. Timing using a clock without a second hand
C. Allowing excess urine to remain on the reagent strip
D. Dipping the reagent strip briefly into the urine specimen

Answer 183

D. Dipping the reagent strip briefly into the urine specimen

Question 184

Select the primary reason why tablet (e.g., Ictotest) and chemical tests (e.g., sulfosalicylic acid precipitation test) generally are performed.
A. They confirm results suspected about the specimen.
B. They are alternative testing methods for highly concentrated urines.
C. Their specificity differs from that of the reagent strip test.
D. They are more sensitive to the chemical constituents in urine.

Answer 184

C. Their specificity differs from that of the reagent strip test.

Question 185

In a patient with chronic renal disease, in whom the kidneys can no longer adjust urine concentration, the urine specific gravity would be
A. 1.000.
B. 1.010.
C. 1.020.
D. 1.030.

Answer 185

B. 1.010.

Question 186

Urine pH normally ranges from
A. 4.0 to 9.0.
B. 4.5 to 7.0.
C. 4.5 to 8.0.
D. 5.0 to 6.0.

Answer 186

C. 4.5 to 8.0.

Question 187

Urine pH can be modified by all of the following EXCEPT
A. diet.
B. increased ingestion of water.
C. ingestion of medications.
D. urinary tract infections.

Answer 187

B. increased ingestion of water.

Question 188

The double-indicator system used by commercial reagent strips to determine urine pH uses which two indicator dyes?
A. Methyl orange and bromphenol blue
B. Methyl red and bromthymol blue
C. Phenol red and thymol blue
D. Phenolphthalein and litmus

Answer 188

B. Methyl red and bromthymol blue

Question 189

Normally, daily urine protein excretion does not exceed
A. 150 mg/day.
B. 500 mg/day.
C. 1.5 g/day.
D. 2.5 g/day.

Answer 189

A. 150 mg/day.

Question 190

Which of the following proteins originates in the urinary tract?
A. Albumin
B. Bence Jones protein
C. β2-Microglobulin
D. Uromodulin

Answer 190

D. Uromodulin

Question 191

Which of the following statements best describes the chemical principle of the protein reagent strip test?
A. The protein reacts with an immunocomplex on the pad, which results in a color change.
B. The protein causes a pH change on the reagent strip pad, which results in a color change.
C. The protein accepts hydrogen ions from the indicator dye, which results in a color change.
D. The protein causes protons to be released from a polyelectrolyte, which results in a color change.

Answer 191

C. The protein accepts hydrogen ions from the indicator dye, which results in a color change.

Question 192

Which of the following aids in the differentiation of hemoglobinuria and hematuria?
A. Urine pH
B. Urine color
C. Leukocyte esterase test
D. Microscopic examination

Answer 192

D. Microscopic examination

Question 193

Which of the following blood cells will not be detected by the leukocyte esterase pad because it lacks esterases?
A. Eosinophils
B. Lymphocytes
C. Monocytes
D. Neutrophils

Answer 193

B. Lymphocytes

Question 194

Microscopic examination of a urine sediment revealed an average of 2 to 5 white blood cells per high-power field, whereas the leukocyte esterase test by reagent strip was negative. Which of the following statements best accounts for this discrepancy?
A. The urine is contaminated with vaginal fluid.
B. Many white blood cells are lysed, and their esterase has been inactivated.
C. Ascorbic acid is interfering with the reaction on the reagent strip.
D. The amount of esterase present is below the sensitivity of the reagent strip test.

Answer 194

D. The amount of esterase present is below the sensitivity of the reagent strip test.

NOTE:
Sensitivity of the pad:
Multistix: 5 to 15 WBCs/hpf
Chemstrip: 10 to 25 WBCs/hpf

Question 195

Which of the following substances or actions can produce FALSE POSITIVE nitrite results?
A. Ascorbic acid
B. Vaginal contamination
C. Strong reducing agents
D. Improper specimen storage

Answer 195

D. Improper specimen storage

Question 196

Which of the following substances if present in the urine results in a negative Clinitest?
A. Fructose
B. Lactose
C. Galactose
D. Sucrose

Answer 196

D. Sucrose

Question 197

The glucose reagent strip test is more sensitive and spe- cific for glucose than the Clinitest method because it detects
A. other reducing substances and higher concentrations of glucose.
B. no other substances and higher concentrations of glucose.
C. other reducing substances and lower concentrations of glucose.
D. no other substances and lower concentrations of glucose

Answer 197

D. no other substances and lower concentrations of glucose

Question 198

The glucose specificity of the double sequential enzyme reaction used on reagent strip tests is due to the use of
A. gluconic acid.
B. glucose oxidase.
C. hydrogen peroxide.
D. peroxidase.

Answer 198

B. glucose oxidase.

Question 199

Which of the following ketones is not detected by the reagent strip or tablet test?
A. Acetone
B. Acetoacetate
C. Acetone and acetoacetate
D. β-Hydroxybutyrate

Answer 199

D. β-Hydroxybutyrate

Question 200

The ketone reagent strip and tablet tests are based on the reactivity of ketones with
A. ferric chloride.
B. ferric nitrate.
C. nitroglycerin.
D. nitroprusside

Answer 200

D. nitroprusside

Question 201

The bilirubin reagent strip and tablet tests are based on
A. Ehrlich’s aldehyde reaction.
B. the oxidation of bilirubin to biliverdin.
C. the reduction of bilirubin to azobilirubin.
D. the coupling of bilirubin with a diazonium salt.

Answer 201

D. the coupling of bilirubin with a diazonium salt.

Question 202

Which of the following are characteristic urine findings from a patient with hemolytic jaundice?
A. A positive test for bilirubin and an increased amount of urobilinogen
B. A positive test for bilirubin and a decreased amount of urobilinogen
C. A negative test for bilirubin and an increased amount of urobilinogen
D. A negative test for bilirubin and a decreased amount of urobilinogen

Answer 202

C. A negative test for bilirubin and an increased amount of urobilinogen

Question 203

Which of the following results shows characteristic urine findings from a patient with an obstruction of the bile duct?
A. A positive test for bilirubin and an increased amount of urobilinogen
B. A positive test for bilirubin and a decreased amount of urobilinogen
C. A negative test for bilirubin and an increased amount of urobilinogen
D. A negative test for bilirubin and a decreased amount of urobilinogen

Answer 203

B. A positive test for bilirubin and a decreased amount of urobilinogen

Question 204

Which of the following conditions can result in FALSE POSITIVE bilirubin results?
A. Elevated concentrations of nitrite
B. Improper storage of the specimen
C. Ingestion of ascorbic acid
D. Ingestion of certain medications

Answer 204

D. Ingestion of certain medications

Question 205

Urobilinogen is formed from the
A. conjugation of bilirubin in the liver.
B. reduction of conjugated bilirubin in bile.
C. reduction of bilirubin by intestinal bacteria.
D. oxidation of urobilin by anaerobic intestinal bacteria.

Answer 205

C. reduction of bilirubin by intestinal bacteria.

Question 206

The classic Ehrlich’s reaction is based on the reaction of urobilinogen with
A. diazotized dichloroaniline.
B. p-aminobenzoic acid.
C. p-dichlorobenzene diazonium salt.
D. p-dimethylaminobenzaldehyde.

Answer 206

D. p-dimethylaminobenzaldehyde.

Question 207

Which of the available chemical principles is MOST SPECIFIC for the detection of urobilinogen?
A. Ictotest
B. Ehrlich’s reaction
C. Azo coupling reaction
D. Double sequential enzyme reaction

Answer 207

C. Azo coupling reaction

NOTE:
Chemstrip incorporates an azo-coupling (diazo) reaction using 4-methoxybenzene-diazonium-tetrafluoroborate to react with urobilinogen. This reaction is more specific for urobilinogen than the Ehrlich reaction.

Question 208

Which of the following reagent strip tests can be affected by ascorbic acid, resulting in falsely low or false-negative results?
1. Blood
2. Bilirubin
3. Glucose
4. Nitrite

A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.

Answer 208

D. All are correct.

Question 209

Which of the following best describes the mechanism of ascorbic acid interference?

A. Ascorbic acid inhibits oxidation of the chromogen.
B. Ascorbic acid inactivates a reactant, promoting color development.
C. Ascorbic acid removes a reactant from the intended reaction sequence.
D. Ascorbic acid interacts with the reactants, producin a color that masks the results.

Answer 209

C. Ascorbic acid removes a reactant from the intended reaction sequence.

NOTE:
Reagent strip tests that use hydrogen peroxide or a diazonium salt are subject to ascorbic acid interference. Whether these compounds are impregnated in the reaction pad or are produced by a first reaction, they are removed by ascorbic acid, which prevents the intended reaction.

Question 210

Smallest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome

Answer 210

D. Wiskott-Aldrich syndrome

Question 211

Largest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome

Answer 211

B. Bernard-Soulier syndrome

Question 212

Sodium citrate in the concentration of a _____ solution has been adopted as the appropriate concentration by the ICSH and the International Society for Thrombosis and Hemostasis for coagulation studies.
A. 1.5%
B. 15%
C. 3.2%
D. 3.8%

Answer 212

C. 3.2%

Question 213

EDTA is used in concentrations of __ of blood.
A. 0.5 mg/1 mL of whole blood
B. 1.5 mg/1 mL of whole blood
C. 2.5 mg/1 mL of whole blood
D. 3.5 mg/1 mL of whole blood

Answer 213

B. 1.5 mg/1 mL of whole blood

Question 214

An HLA specimen is collected in a tube containing:
A. ACD
B. EDTA
C. Silica
D. Thrombin

Answer 214

A. ACD

Question 215

Most common complication encountered in obtaining a blood specimen:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these

Answer 215

A. Ecchymosis (bruise)

Question 216

It is caused by leakage of a SMALL AMOUNT OF BLOOD in the tissue around the puncture site:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these

Answer 216

A. Ecchymosis (bruise)

Question 217

Leakage of a LARGE AMOUNT OF BLOOD around the puncture site causes the area to rapidly swell:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these

Answer 217

B. Hematoma

Question 218

Phlebotomy complications including diaphoresis, seizure, pain, and nerve damage:
A. Cardiovascular complications
B. Vascular complications
C. Neurological complications
D. Infections

Answer 218

C. Neurological complications

Question 219

Cardiovascular complications of phlebotomy:
1. Cardiac arrest
2. Hypotension
3. Syncope
4. Shock

A. 1 and 2
B. 1 and 3
C. 1, 2 and 3
D. 1, 2, 3 and 4

Answer 219

D. 1, 2, 3 and 4

Question 220

Which of the following is the medical term for fainting?
A. Sclerosis
B. Stasis
C. Supine
D. Syncope

Answer 220

D. Syncope

Question 221

An inpatient vehemently refuses to allow you to collect a blood specimen. What should you do?
A. Convince the patient to cooperate and collect the sample anyway.
B. Have the nurse physically restrain the patient and draw the specimen.
C. Notify the patient’s nurse and document the patient’s refusal.
D. Return to the lab, cancel the test request, and inform the physician.

Answer 221

C. Notify the patient’s nurse and document the patient’s refusal.

Question 222

Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do?
A. Ask the patient to state her name; if it matches the requisition, continue.
B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.
C. Go to the nurses’ station, get an ID bracelet, attach it, and then proceed.
D. Tell the nurse that you will not collect the specimen and return to the lab.

Answer 222

B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.

Question 223

A phlebotomist who encounters a comatose patient with no ID band should:
A. Notify the phlebotomy supervisor
B. Check the patient’s identify with the patient’s roommate
C. Leave the requisition at the nurse’s station
D. Ask the nurse to band the patient

Answer 223

D. Ask the nurse to band the patient

Question 224

A solution used to clean the site before routine venipuncture is:
A. 5.25% sodium hypochlorite.
B. 70% isopropyl alcohol.
C. 70% methanol.
D. Povidone–iodine.

Answer 224

B. 70% isopropyl alcohol.

Question 225

This antiseptic has been traditionally used to obtain the high degree of skin antisepsis required when BLOOD CULTURES are being collected:
A. 70% Ethyl alcohol
B. 70% Isopropanol
C. Hydrogen peroxide
D. Povidone–iodine

Answer 225

D. Povidone–iodine

Question 226

When drawing a blood alcohol specimen, it is acceptable to clean the arm with:
A. Benzalkonium chloride
B. Isopropyl alcohol
C. Methanol prep.
D. Tincture of iodine

Answer 226

A. Benzalkonium chloride

Question 227

Stem cells are present in the first few hours after an ovum is fertilized; most versatile type of stem cell:
A. Multipotential stem cells
B. Pluripotential stem cells
C. Totipotential stem cells
D. Any of these

Answer 227

C. Totipotential stem cells

Question 228

Disseminated intravascular coagulation (DIC) is most often associated with which of the following types of acute leukemia?
A. Acute myeloid leukemia without maturation
B. Acute promyelocytic leukemia
C. Acute myelomonocytic leukemia
D. Acute monocytic leukemia

Answer 228

B. Acute promyelocytic leukemia

Question 229

Fibrinogen in Hemophilia A:
A. Normal
B. Decreased
C. Increased
D. Variable

Answer 229

A. Normal

Question 230

Fibrinogen in vWD:
A. Normal
B. Decreased
C. Increased
D. Variable

Answer 230

A. Normal

Question 231

Fibrinogen in Hemophilia B:
A. Normal
B. Decreased
C. Increased
D. Variable

Answer 231

A. Normal

Question 232

Fibrinogen in Hemophilia C:
A. Normal
B. Decreased
C. Increased
D. Variable

Answer 232

A. Normal

Question 233

Fibrinogen in Primary Fibrinolysis:
A. Normal
B. Decreased
C. Increased
D. Variable

Answer 233

B. Decreased

Question 234

Fibrinogen in Secondary Fibrinolysis:
A. Normal
B. Decreased
C. Increased
D. Variable

Answer 234

B. Decreased

Question 235

Factor VII deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT

Answer 235

B. Prolonged PT, Normal APTT, Normal TCT

Question 236

Hemophilia A:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT

Answer 236

A. Normal PT, Prolonged APTT, Normal TCT

Question 237

Factor X deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT

Answer 237

C. Prolonged PT and APTT, Normal TCT

Question 238

Fibrinogen deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT

Answer 238

D. Prolonged PT, APTT and TCT

Question 239

Acute, uncompensated DIC
1. Prolonged PT, PTT and TT
2. Normal fibrinogen
3. Increased FDPs

A. 1 only
B. 1 and 2
C. 1 and 3
D. 1, 2 and 3

Answer 239

C. 1 and 3

Question 240

The only abnormal test result in CHRONIC DIC:
A. PT
B. APTT
C. Thrombin time
D. D-dimer

Answer 240

D. D-dimer

Question 241

Neutrophil in the maturation-storage phase:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours

Answer 241

B. 7 to 10 days

Question 242

Basophil in the maturation-storage phase:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours

Answer 242

D. 12 hours

Question 243

Eosinophil in the maturation-storage phase:
A. 2.5 days
B. 3.5 days
C. 8.5 hours
D. 12 hours

Answer 243

A. 2.5 days

Question 244

Average life span of neutrophils in circulating blood:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours

Answer 244

A. 7 to 10 hours

Question 245

Average life span of basophils in circulating blood:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours

Answer 245

C. 8.5 hours

Question 246

Eosinophils remain in the maturation-storage phase for about:
A. 2 days
B. 2.5 days
C. 3 days
D. 3.5 days

Answer 246

B. 2.5 days

Question 247

The time from the last myelocyte mitotic division to the emergence of mature eosinophils from the marrow is about:
A. 2 days
B. 2.5 days
C. 3 days
D. 3.5 days

Answer 247

D. 3.5 days

Question 248

Which of the following is contained in the primary granules of the neutrophil?
A. Lactoferrin
B. Myeloperoxidase
C. Histamine
D. Alkaline phosphatase

Answer 248

B. Myeloperoxidase

Question 249

NEW TYPES OF THROMBOPLASTINS for measuring the PT are mixtures of phospholipids and recombinantly derived from:
A. Rabbit tissue factor
B. Human tissue factor
C. Horse tissue factor
D. Sheep tissue factor

Answer 249

B. Human tissue factor

Question 250

Plasma thromboplastin antecedent:
A. Factor V
B. Factor IX
C. Factor XI
D. Factor XII

Answer 250

C. Factor XI

Question 251

Plasma thromboplastin component:
A. Factor V
B. Factor IX
C. Factor XI
D. Factor XII

Answer 251

B. Factor IX

Question 252

The prothrombin assay requires that the patient’s citrated plasma be combined with which one of the following?
A. Thromboplastin
B. Calcium chloride and thromboplastin
C. Calcium chloride
D. Kaolin

Answer 252

B. Calcium chloride and thromboplastin

Question 253

Assess deficiencies of all factors except VII and XIII:
A. Platelet count
B. Prothrombin time (PT)
C. Partial thromboplastin time (PTT)
D. Thrombin time

Answer 253

C. Partial thromboplastin time (PTT)

Question 254

Hemoglobin appears for the first time:
A. Pronormoblast
B. Basophilic normoblast
C. Polychromatophilic normoblast
D. Orthochromic normoblast

Answer 254

C. Polychromatophilic normoblast

Question 255

The heme portion of the hemoglobin molecule consists of ____ iron (Fe2+) atom(s) and ____ pyrrole rings that are joined to each other.
A. One iron and two pyrrole rings
B. One iron and four pyrrole rings
C. Two iron and four pyrrole rings
D. Four iron and four pyrrole rings

Answer 255

B. One iron and four pyrrole rings

Question 256

Which globin chains compose hemoglobin A1?
A. Two alpha chains and two beta chains
B. Two alpha chains and two delta chains
C. Two alpha chains and two gamma chains
D. Two beta chains and two delta chains

Answer 256

A. Two alpha chains and two beta chains

Question 257

Decreased production of erythropoietin by the damaged kidney:
A. Anemia of chronic disease
B. Anemia of renal insufficiency
C. Anemia in liver disease
D. Anemia in endocrine disease

Answer 257

B. Anemia of renal insufficiency

Question 258

Which of the following is likely to occur FIRST in iron deficiency anemia?
A. Decreased serum iron
B. Increased TIBC
C. Decreased serum ferritin
D. Increased transferrin

Answer 258

C. Decreased serum ferritin

Question 259

All of the following are embryonic hemoglobin, except:
A. Gower 1 hb
B. Gower 2 hb
C. Portland 1 hb
D. Portland 2 hb

Answer 259

D. Portland 2 hb

Question 260

Hb A1:
A. 2 alpha + 2 beta globin chains
B. 2 alpha + 2 delta globin chains
C. 2 alpha + 2 delta globin chains
D. 2 zeta + 2 epsilon globin chains

Answer 260

A. 2 alpha + 2 beta globin chains

Question 261

Hb F:
A. 2 alpha + 2 beta globin chains
B. 2 alpha + 2 delta globin chains
C. 2 alpha + 2 gamma globin chains
D. 2 zeta + 2 epsilon globin chains

Answer 261

C. 2 alpha + 2 gamma globin chains

Question 262

Which mutation is shared by a large percentage of patients with polycythemia vera, essential thrombocythemia, and primary myelofibrosis?
A. BCR/ABL
B. JAK2 V617F
C. PDGFR
D. RUNX1

Answer 262

B. JAK2 V617F

Question 263

The level of erythropoietin in the urine is _____ in patients with PV compared with other kinds of polycythemia.
A. Increased
B. The same
C. Variable
D. Decreased

Answer 263

D. Decreased

Question 264

Aspirin ingestion has the following hemostatic effect in a normal person.
A. Prolongs the bleeding time
B. Prolongs the clotting time
C. Inhibits factor VIII
D. Has no effect

Answer 264

A. Prolongs the bleeding time

Question 265

A donor taking Feldene will not be able to donate platelets for:
A. 2 days
B. 7 days
C. 2 weeks
D. 4 weeks

Answer 265

A. 2 days

Question 266

A whole-blood donor currently on clopidogrel (Plavix) is precluded from donating which product?
A. Platelets
B. Red blood cells
C. FFP
D. Cryoprecipitate

Answer 266

A. Platelets

Question 267

A prolonged thrombin time is indicative of which of the following antithrombotic therapies?
A. Prasugrel
B. Clopidogrel
C. Aspirin
D. Heparin

Answer 267

D. Heparin

Question 268

What test is commonly used to monitor warfarin therapy
A. INR
B. APTT
C. TT
D. Ecarin time

Answer 268

A. INR

Question 269

What test is used to monitor heparin therapy?
A. INR
B. APTT
C. TT
D. PT

Answer 269

B. APTT

Question 270

POCT/BED-SIDE
Which of the following is the preferred method to monitor heparin therapy at the point of care during cardiac surgery?
A. APTT
B. Activated clotting time test (ACT)
C. PT
D. TT

Answer 270

B. Activated clotting time test (ACT)

Question 271

What clotting factors (cofactors) are inhibited by protein S?
A. V and X
B. Va and VIIIa
C. VIII and IX
D. VIII and X

Answer 271

B. Va and VIIIa

Question 272

Phlebotomy is used as a therapeutic treatment for:
A. Diabetes
B. Hypothyroidism
C. Phlebitis
D. Polycythemia

Answer 272

D. Polycythemia

Question 273

A modification of which procedure can be used to measure fibrinogen?
A. PT
B. APTT
C. Thrombin time
D. Fibrin degradation products

Answer 273

C. Thrombin time

Question 274

More than half of the cases have been described in Ashkenazi Jews, but individuals of any ethnic group may be affected:
A. Hemophilia A
B. Hemophilia B
C. Hemophilia C
D. vWD

Answer 274

C. Hemophilia C

Question 275

What coagulation plasma protein should be assayed when platelets fail to aggregate properly?
A. Factor VIII
B. Fibrinogen
C. Thrombin
D. Factor X

Answer 275

B. Fibrinogen

Question 276

A patient on therapeutic warfarin will most likely have a(n)
A. Normal PT/INR, increased APTT, prolonged bleeding time, low platelet count
B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count
C. Normal PT/INR, normal APTT, normal bleeding time, normal platelet count
D. Increased PT/INR, normal APTT, prolonged bleeding time, low platelet count

Answer 276

B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count

Question 277

This organ is usually suspended whole in 10% buffered formalin for 2 to 3 weeks to ensure fixation and some hardening prior to sectioning.
A. Lungs
B. Liver
C. Brain
D. Amputated foot

Answer 277

C. Brain

Question 278

Which of the following organs should not be dissected before they are fixed?
A. Eyes
B. Lungs
C. Heart
D. Liver

Answer 278

A. Eyes

Question 279

A blood service facility duly authorized by the DOH – Center for Health Development (CHD), whose main function is to collect blood from volunteer non-renumerated blood donors:
A. Blood Bank (BB)
B. Blood center (BC)
C. Blood collection unit (BCU)
D. Blood station (BS)

Answer 279

C. Blood collection unit (BCU)

Question 280

A blood service facility duly authorized by the DOH – CHD, whose main function is the storage, issuance, transport and distribution of whole blood and packed red cells:
A. Blood Bank (BB)
B. Blood center (BC)
C. Blood collection unit (BCU)
D. Blood station (BS)

Answer 280

D. Blood station (BS)

Question 281

A non-hospital-based blood service facility, licensed by DOH Bureau of Health Facilities and Services (BHFS), whose main function is to process blood units into blood components and testing these units for five (5) infectious disease markers:
A. Blood Bank (BB)
B. Blood center (BC)
C. Blood collection unit (BCU)
D. Blood station (BS)

Answer 281

B. Blood center (BC)

Question 282

All of the following bacterial cell walls contains mycolic acid, EXCEPT:
A. Nocardia
B. Rhodococcus
C. Streptomyces
D. Corynebacterium

Answer 282

C. Streptomyces

Question 283

The unique chemical structure of the cell wall of Mycobacterium spp. is associated with the presence of:
A. N-glycolylmuramic acid and a decrease in lipid content
B. N-acetylmuramic acid and a decrease in lipid content
C. N-glycolylmuramic acid and an increase in lipid content
D. N-acetylmuramic acid and an increase in lipid content

Answer 283

C. N-glycolylmuramic acid and an increase in lipid content

Question 284

For manual WBC count, allow the dilution to sit for ________ to ensure that the red blood cells have lysed.
A. 3 minutes
B. 5 minutes
C. 10 minutes
D. 15 minutes

Answer 284

C. 10 minutes

Question 285

For manual WBC count, after charging the hemacytometer, place it in a moist chamber for _______ before counting the cells to give them time to settle.
A. 3 minutes
B. 5 minutes
C. 10 minutes
D. 15 minutes

Answer 285

C. 10 minutes

Question 286

For manual platelet count, place the charged hemacytometer in a moist chamber for _________ to allow the platelets to settle.
A. 3 minutes
B. 5 minutes
C. 10 minutes
D. 15 minutes

Answer 286

D. 15 minutes

Question 287

Full conversion of hemoglobin to cyanmethemoglobin:
A. 1 minute
B. 3 minutes
C. 10 minutes
D. 30 minutes

Answer 287

C. 10 minutes

Question 288

High WBC count that can cause turbidity and a falsely high hemoglobin result:
A. WBCs > 10 x 10 9th/L
B. WBCs > 20 x 10 9th/L
C. WBCs > 50 x 10 9th/L
D. WBCs > 70 x 10 9th/L

Answer 288

B. WBCs > 20 x 10 9th/L

Question 289

High platelet count that can cause turbidity and a falsely high hemoglobin result:
A. Platelets > 150 x 10 9th/L
B. Platelets > 200 x 10 9th/L
C. Platelets > 500 x 10 9th/L
D. Platelets > 700 x 10 9th/L

Answer 289

D. Platelets > 700 x 10 9th/L

Question 290

When the correct area of a specimen from a patient with a normal RBC count is viewed, there are generally about ____ RBCs per 100x oil immersion field.
A. 10 to 15 RBCs per OIF
B. 20 to 25 RBCs per OIF
C. 100 to 150 RBCs per OIF
D. 200 to 250 RBCs per OIF

Answer 290

D. 200 to 250 RBCs per OIF

Question 291

To evaluate normal platelet numbers in an appropriate area of a blood smear, approximately how many platelets should be observed per oil immersion field?
A. 1-4
B. 4-10
C. 8-20
D. 20-50

Answer 291

C. 8-20

Question 292

A widely used hemagglutination test for detecting antibody to Treponema pallidum is:
A. MHA-TP test
B. FTA-ABS test
C. VDRL test
D. Hemagglutination inhibition assay

Answer 292

A. MHA-TP test

Question 293

All of the following are primary manifestations of Legionnaires’ disease except?
A. Trench fever
B. Pontiac fever
C. Endocarditis
D. Pneumonia

Answer 293

A. Trench fever

Question 294

Which of the following agars should be used for culturing Legionella?
A. CIN
B. BCYE
C. SMAC
D. XLD

Answer 294

B. BCYE

Question 295

The filovirus that has a characteristic “shepherd’s hook” morphology when viewed by electron microscopy is:
A. Ebola Zaire virus
B. Ebola Reston virus
C. Ebola Sudan virus
D. Marburg virus

Answer 295

D. Marburg virus

Question 296

What is the safe volume of blood to be drawn for pediatric blood cultures?
A. <1 mL
B. 1 to 5 mL
C. 5 to 10mL
D. 10 to 20 mL

Answer 296

B. 1 to 5 mL

NOTE:
For infants and small children, only 1 to 5 mL of blood should be drawn for bacterial culture.

Question 297

Psittacosis is a lower respiratory infection in humans caused by contact with what animal?
A. Swine
B. Seals
C. Cats
D. Birds

Answer 297

D. Birds

Question 298

What is the primary etiologic agent in children with epiglottitis?
A. Haemophilus influenzae type b
B. Corynebacterium diphtheriae
C. Streptococcus pyogenes
D. Staphylococcus aureus

Answer 298

A. Haemophilus influenzae type b

Question 299

What virus traditionally causes viral parotitis?
A. Influenza virus
B. Parainfluenza virus
C. Rhinovirus
D. Mumps virus

Answer 299

D. Mumps virus

Question 300

When setting up a urine culture, a calibrated loop is used that delivers a specific amount of urine to the media plate. What is that amount?
A. 0.01 or 0.001 mL of urine
B. 0.10 or 0.01 mL of urine
C. 0.001 or 0.0001 mL of urine
D. None of the above is correct

Answer 300

A. 0.01 or 0.001 mL of urine

NOTE:
Most often, microbiologists use a calibrated loop designed to deliver a known volume, either 0.01 or 0.001 mL of urine.
These loops, made of platinum, plastic, or other material, can be obtained from laboratory supply companies.
The calibrated loop that delivers the larger volume of urine (0.01 mL) is recommended to detect lower numbers of organisms in certain specimens.

Question 301

Which organism is associated with thrombotic thrombocytopenia purpura?
A. Shigella dysenteriae
B. Clostridium difficile
C. EHEC (VTEC)
D. Vibrio cholerae

Answer 301

C. EHEC (VTEC)

Question 302

Poor dental hygiene can lead to osteomyelitis of the jaw; what organism is most often responsible for this type of infection?
A. Actinomyces spp.
B. Staphylococcus aureus
C. Prevotella spp.
D. Fusobacterium spp.

Answer 302

A. Actinomyces spp.

Question 303

OFTEN RECOVERED FROM PATIENTS WITH MALIGNANCIES OF COLON
Anaerobic gram-positive bacilli with subterminal spores were recovered from several blood cultures obtained from a patient diagnosed with a malignancy of the colon. The following results were recorded:
* Indole = Neg
* Urease = Neg
* Lipase = Neg
* Catalase = Neg
* Lecithinase = Neg
* Growth on blood agar = Swarming colonies

What is the correct identification?
A. Clostridium septicum
B. Clostridium perfringens
C. Clostridium sordellii
D. Propionibacterium acnes

Answer 303

A. Clostridium septicum

Question 304

Slowly multiplying trophozoite stage of Toxoplasma gondii:
A. Gametocyte
B. Sporozoite
C. Bradyzoite
D. Tachyzoite

Answer 304

C. Bradyzoite

Question 305

Rapidly multiplying trophozoite stage of Toxoplasma gondii:
A. Gametocyte
B. Sporozoite
C. Bradyzoite
D. Tachyzoite

Answer 305

D. Tachyzoite

Question 306

The two species of flies responsible for the transmission are Glossina palpalis and Glossina tachinoides:
A. Leishmania donovani
B. Leishmania tropica
C. Trypanosoma brucei gambiense
D. Trypanosoma brucei rhodesiense

Answer 306

C. Trypanosoma brucei gambiense

Question 307

The two primary species of fly vectors responsible for transmitting are Glossina morsitans and Glossina pallidipes:
A. Leishmania donovani
B. Leishmania tropica
C. Trypanosoma brucei gambiense
D. Trypanosoma brucei rhodesiense

Answer 307

D. Trypanosoma brucei rhodesiense

Question 308

When undercooked meat is digested in the stomach, the larvae are resistant to the gastric pH and pass to the intestine, where they invade the mucosa:
A. Ancylostoma duodenale
B. Ascaris lumbricoides
C. Dracunculus medinesis
D. Trichinella spiralis

Answer 308

D. Trichinella spiralis

Question 309

Most common identified species of filarial worms that infect humans:
A. Brugia malayi
B. Loa loa
C. Mansonella ozzardi
D. Wuchereria bancrofti

Answer 309

D. Wuchereria bancrofti

Question 310

Sheathed microfilaria, nuclei continuous up to the tip of the tail:
A. B. malayi
B. L.loa
C. O. volvulus
D. W. bancrofti

Answer 310

B. L.loa

Question 311

Definitive host and the reservoir for W. bancrofti:
A. Anopheles
B. Aedes
C. Culex fatigans
D. Human

Answer 311

D. Human

Question 312

Tail is often referred to as “SHEPHERD’S CROOK”:
A. Onchocerca volvulus
B. Mansonella perstans
C. Mansonella ozzardi
D. Mansonella streptocerca

Answer 312

D. Mansonella streptocerca

Question 313

Infective stage is the SHEATHED FILARIFORM LARVA:
A. Strongyloides stercoralis
B. Ancylostoma duodenale, Necator americanus
C. Ascaris lumbricoides
D. Enterobius vermicularis

Answer 313

B. Ancylostoma duodenale, Necator americanus

Question 314

Infective stage is the UNSHEATHED FILARIFORM LARVA:
A. Strongyloides stercoralis
B. Ancylostoma duodenale, Necator americanus
C. Ascaris lumbricoides
D. Enterobius vermicularis

Answer 314

A. Strongyloides stercoralis

Question 315

Eggs can be confused with POLLEN GRAINS:
A. Diphyllobothrium latum
B. Dipylidium caninum
C. Hymenolepis nana
D. Taenia spp.

Answer 315

D. Taenia spp.

Question 316

Gravid proglottids resemble RICE GRAINS (dry) or CUCUMBER SEEDS (moist):
A. Diphyllobothrium latum
B. Dipylidium caninum
C. Hymenolepis nana
D. Taenia spp.

Answer 316

B. Dipylidium caninum

Question 317

Oxidase positive, urease negative:
A. B. pertussis
B. B. parapertussis
C. B. bronchiseptica
D. None of these

Answer 317

A. B. pertussis

Question 318

Oxidase and urease positive:
A. B. pertussis
B. B. parapertussis
C. B. bronchiseptica
D. None of these

Answer 318

C. B. bronchiseptica

Question 319

Oxidase negative, urease positive:
A. B. pertussis
B. B. parapertussis
C. B. bronchiseptica
D. None of these

Answer 319

B. B. parapertussis

Question 320

Catalase positive, lactose negative, xylose positive:
A. Haemophilus aegypticus
B. Haemophilus ducreyi
C. Haemophilus parainfluenzae
D. Haemophilus influenzae

Answer 320

D. Haemophilus influenzae

Question 321

More likely to contain trophozoites:
A. Liquid/diarrheic stool
B. Formed stool
C. Soft stool
D. None of these

Answer 321

A. Liquid/diarrheic stool

Question 322

May contain trophozoites and cysts:
A. Liquid stool
B. Diarrheic stool
C. Formed stool
D. Soft stool

Answer 322

D. Soft stool

Question 323

More likely to contain cysts (less likely to contain trophozoites)
A. Liquid stool
B. Diarrheic stool
C. Formed stool
D. Soft stool

Answer 323

C. Formed stool

Question 324

Feather-edged colonies usually surrounded by zone of green discoloration; produces a highly characteristic, fruity odor resembling apples or strawberries:
A. Achromobacter denitrificans
B. Pseudomonas alcaligenes
C. Pseudomonas pseudoalcaligenes
D. Alcaligenes faecalis

Answer 324

D. Alcaligenes faecalis

Question 325

Distinct odor that is often referred to as a “chocolate cake” or “burnt chocolate” smell:
A. Burkholderia cepacia
B. Eikenella corrodens
C. Proteus sp.
D. Staphylococcus aureus

Answer 325

C. Proteus sp.

Question 326

RTE cell from the proximal convoluted tubules:
A. Columnar or convoluted
B. Cuboidal
C. Round or oval
D. None of these

Answer 326

A. Columnar or convoluted

Question 327

RTE cell from the distal convoluted tubules:
A. Columnar or convoluted
B. Cuboidal
C. Round or oval
D. None of these

Answer 327

C. Round or oval

Question 328

RTE cells from the collecting duct:
A. Columnar or convoluted
B. Cuboidal
C. Round or oval
D. None of these

Answer 328

B. Cuboidal

Question 329

As little as 0.1 mL of CSF combined with one drop of _______ produces an adequate cell yield when processed with the cytocentrifuge.
A. 10% formalin
B. 40% formalin
C. 10% albumin
D. 30% albumin

Answer 329

D. 30% albumin

Question 330

A DAILY CONTROL SLIDE FOR BACTERIA IN CSF:
A. 95% ethanol
B. 30% albumin
C. 0.2 mL saline and 2 drops 95% ethanol
D. 0.2 mL saline and 2 drops 30% albumin

Answer 330

D. 0.2 mL saline and 2 drops 30% albumin

Question 331

Hepatocellular damage may be best assessed by which of the following parameters?
A. Serum AST and ALT levels
B. GGT and ALP
C. Bilirubin, GGT, and ALP
D. Ammonia and urea

Answer 331

A. Serum AST and ALT levels

Question 332

Which of the following analytes is the best indicator of hepatobiliary damage?
A. AST
B. ALT
C. ALP
D. Bilirubin

Answer 332

C. ALP

Question 333

Fluorophore-labeled thyroxine competes with patient thyroxine for antibody in homogeneous system. Antibody-bound labeled thyroxine rotates slowly, emitting lower energy light.
A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)

Answer 333

A. Fluorescent polarization immunoassay (FPIA)

Question 334

Fluorogenic substrate–labeled TSH is competing with patient TSH for antibody in this homogeneous assay. Only unbound (leftover) labeled TSH reacts with the enzyme to form fluorescent product. There is a direct relationship between fluorescence and the amount of TSH present in the test sample.
A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)

Answer 334

B. Fluorescent substrate-labeled inhibition immunoassay

Question 335

Peroxidase-labeled antibody binds with patient hormone (antigen) to form complex (similar to ELISA). Addition of luminol or acridium esters substrate forms an oxidized product that emits light for short time.
A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)

Answer 335

C. Chemiluminescence

Question 336

Similar to ELISA in that there is a double-antibody system that forms a “sandwich” with the hormone:
A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)

Answer 336

D. Microparticle enzyme immunoassay (MEIA)

Question 337

Primary hyperthyroidism:
A. Normal T3 T4, increased TSH
B. Normal T3 T4, decreased TSH
C. Increased T3 T4, increased TSH
D. Increased T3 T4, decreased TSH

Answer 337

D. Increased T3 T4, decreased TSH

Question 338

Secondary hyperthyroidism:
A. Normal T3 T4, increased TSH
B. Normal T3 T4, decreased TSH
C. Increased T3 T4, increased TSH
D. Increased T3 T4, decreased TSH

Answer 338

C. Increased T3 T4, increased TSH

Question 339

Subclinical hyperthyroidism:
A. Normal T3 T4, increased TSH
B. Normal T3 T4, decreased TSH
C. Increased T3 T4, increased TSH
D. Increased T3 T4, decreased TSH

Answer 339

B. Normal T3 T4, decreased TSH

Question 340

Wastes of Lean:
1. Defects
2. Waiting
3. Motion
4. Emotion

A. 1 and 3
B. 2 and 4
C. 1, 2 and 3
D. 1, 2, 3 and 4

Answer 340

C. 1, 2 and 3

Question 341

Speed and time of rotation for serum VDRL test:
A. 100 rpm for 4 minutes
B. 100 rpm for 8 minutes
C. 180 rpm for 4 minutes
D. 180 rpm for 8 minutes

Answer 341

C. 180 rpm for 4 minutes

Question 342

Speed and time of rotation for CSF VDRL test:
A. 100 rpm for 4 minutes
B. 100 rpm for 8 minutes
C. 180 rpm for 4 minutes
D. 180 rpm for 8 minutes

Answer 342

D. 180 rpm for 8 minutes

Question 343

Speed and time of rotation for RPR:
A. 100 rpm for 4 minutes
B. 100 rpm for 8 minutes
C. 180 rpm for 4 minutes
D. 180 rpm for 8 minutes

Answer 343

B. 100 rpm for 8 minutes

Question 344

Black belts dedicate _______ of their time to quality improvement projects, proactively addressing process and quality problems.
A. 10%
B. 20%
C. 70%
D. 100%

Answer 344

D. 100%

Question 345

Green belts contribute ______ of their time to improvement projects while delivering their normal job functions.
A. 10%
B. 20%
C. 70%
D. 100%

Answer 345

B. 20%

Question 346

Black belts
A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used

Answer 346

B. Project coaches or leaders

Question 347

Green belts
A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used

Answer 347

C. Project team members

Question 348

Blue belts
A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used

Answer 348

A. Project sponsors or champions

Question 349

A nurse calls the laboratory technologist on duty asking about blood collection for the analysis of enzymes (AST, ALP, ALT, GGT, CK). Which of the following tubes would you suggest the technologist collect?
A. Red top
B. EDTA
C. Oxalate
D. Fluoride

Answer 349

A. Red top

Question 350

Primum non nocere comes from the Hippocratic Oath and means:
A. To first things first.
B. First do no harm.
C. Quality is foremost.
D. Ready to serve.

Answer 350

B. First do no harm.

Question 351

Phlebos = vein; tome = incision
The term phlebotomy is derived from Greek words that, literally translated, mean to:
A. Cut a vein.
B. Draw blood.
C. Stick a vein.
D. Withdraw blood.

Answer 351

A. Cut a vein.

Question 352

CONTACT PRECAUTION
Which of the following patients would require contact precautions pending a diagnosis?
A. A child with a maculopapular rash highly suggestive of rubeola (measles)
B. A diapered patient with symptoms of infection with an enteric pathogen
C. An HIV-positive patient who has a cough, fever, and pulmonary infiltrate
D. A man with a severe persistent cough indicative of Bordetella pertussis

Answer 352

B. A diapered patient with symptoms of infection with an enteric pathogen

Question 353

When the chain of infection is broken, an:
A. Individual is immune to that microbe.
B. Individual is susceptible to infection.
C. Infection is prevented from happening.
D. Infection will most likely be the result.

Answer 353

C. Infection is prevented from happening.

Question 354

Which type of precautions would be used for a patient who has pulmonary tuberculosis?
A. Airborne
B. Droplet
C. Contact
D. Reverse

Answer 354

A. Airborne

Question 355

DROPLET PRECAUTION
An example of a disease requiring droplet isolation is:
A. Pertussis.
B. Rubeola.
C. Scabies.
D. Varicella

Answer 355

A. Pertussis.

Question 356

Class C fires involve:
A. Combustible metals.
B. Electrical equipment.
C. Flammable liquids.
D. Ordinary materials.

Answer 356

B. Electrical equipment.

Question 357

This equipment is required when one is collecting a specimen from a patient in airborne isolation.
A. Eye protection
B. Full face shield
C. Mask and goggles
D. N95 respirator

Answer 357

D. N95 respirator

Question 358

You accidentally splash a bleach solution into your eyes while preparing it for cleaning purposes. What is the first thing to do
A. Dry your eyes quickly with a clean paper towel or tissue.
B. Flush your eyes with water for a minimum of 15 minutes.
C. Proceed to the emergency room as quickly as possible.
D. Put 10 to 20 drops of saline into your eyes immediately.

Answer 358

B. Flush your eyes with water for a minimum of 15 minutes.

Question 359

The first thing to do in the event of electrical shock to a coworker or patient is to:
A. Call for medical assistance.
B. Keep the patient warm.
C. Shut off the electricity source.
D. Start CPR if indicated.

Answer 359

C. Shut off the electricity source.

Question 360

Alcohol-based antiseptic hand cleaners can be used in place of hand washing if:
A. Gloves were worn during the prior activity.
B. Hands are first cleaned with detergent wipes.
C. Hands were washed after the prior activity.
D. No dirt or organic matter is seen on the hands.

Answer 360

D. No dirt or organic matter is seen on the hands.

Question 361

Most reference ranges are based on normal laboratory test values for:
A. Fasting patients.
B. Healthy people.
C. ill individuals.
D. Treated patients.

Answer 361

B. Healthy people.

Question 362

PLUMBISM - deleterious effect of gradual accumulation of ______ in body tissues, as a result of repeated exposure.
A. Arsenic
B. Cyanide
C. Lead
D. Mercury

Answer 362

C. Lead

Question 363

Two standard deviations (2 SD) from the mean in a normal distribution curve would include:
A. 99% of all values
B. 95% of all values
C. 75% of all values
D. 68% of all values

Answer 363

B. 95% of all values

Question 364

Acceptable limits of a control value must fall:
A. Within ±1 standard deviation of the mean
B. Between 1 and 2 standard deviations of the mean
C. Within ±2 standard deviations of the mean
D. Within ±3 standard deviations of the mean

Answer 364

C. Within ±2 standard deviations of the mean

Question 365

Typically, a patient test result that EXCEEDS 3 SD of the mean value for analyte is found with a frequency of:
A. 1 in 5
B. 1 in 20
C. 1 in 100
D. Never

Answer 365

C. 1 in 100

Question 366

Potentiometric methods are most useful for which of the following types of analytes?
A. Proteins
B. Electrolytes
C. Drugs of abuse
D. Lipids

Answer 366

B. Electrolytes

Question 367

Which of the following tests is a good marker of nutritional status?
A. Immunoglobulin M
B. Prealbumin
C. Ceruloplasmin
D. Lp(a)

Answer 367

B. Prealbumin

Question 368

Which test is used as an indicator of congestive heart failure?
A. CRP
B. BNP
C. Cholesterol
D. Troponin
E. Haptoglobin

Answer 368

B. BNP

Question 369

Which test is the most specific for myocardial infarction?
A. LDH
B. CK
C. Troponin
D. Myoglobin

Answer 369

C. Troponin

Question 370

In which condition would TIBC be high?
A. Hemochromatosis
B. Chronic illness
C. Malnutrition
D. Iron deficiency

Answer 370

D. Iron deficiency

Question 371

When performing a stool culture, a colony type typical of an enteric pathogen is subcultured on a blood agar plate. The resulting pure culture is screened with several tests to obtain the following results:
* TSI: acid butt, alkaline slant, no gas, no H2S
* Phenylalanine deaminase: negative
* Motility: positive
* Serological typing: Shigella flexneri (Shigella subgroup B)

The serological typing is verified with new kit and controls. The best course of action would be to:

A. Report the organism as Shigella flexneri without further testing
B. Verity reactivity of motility medium with positive and negative controls
C. Verify reactivity of the TSI slants with positive and negative controls for H2S production
D. Verify reactivity of phenylalanine deaminase with positive and negative controls

Answer 371

B. Verity reactivity of motility medium with positive and negative controls

Question 372

In order to isolate Campylobacter coli/jejuni, the fecal specimen should be:
A. Inoculated onto selective plating media and incubated in reduced oxygen with added CO2 at 42°C
B. Stored in tryptic soy broth before plating to ensure growth of the organism
C. Inoculated onto selective plating media and incubated at both 35°C and at room temperature
D. Incubated at 35°C for 2 hours in Cary-Blair media before inoculating onto selective plating media

Answer 372

A. Inoculated onto selective plating media and incubated in reduced oxygen with added CO2 at 42°C

Question 373

A liquid fecal specimen from a three-month-old infant is submitted for microbiological examination. In addition to culture on routine media for Salmonella and Shigella, this specimen should be routinely:
A. Examined for the presence of Entamoeba hartmanni
B. Examined for the presence of Camylobacter sp.
C. Screened for the detection of enterotoxigenic Escherichia coli
D. Placed in thioglycollate broth to detect Clostridium botulinum

Answer 373

B. Examined for the presence of Camylobacter sp.

Question 374

Of the following bacteria, the most frequent cause of prosthetic heart valve infections occurring within 2 to 3 months after surgery is:
A. Streptococcus pneumoniae
B. Streptococcus pyogenes
C. Staphylococcus aureus
D. Staphylococcus epidermidis

Answer 374

D. Staphylococcus epidermidis

Question 375

The following results were obtained from a culture of unknown origin:
* Gram stain: gram-negative diplococci
* Indophenol oxidase: positive
* Glucose: positive
* Maltose: negative
* Sucrose: negative

The most likely source of the specimen would be the:
A. Respiratory tract
B. Blood
C. Genitourinary tract
D. Cerebrospinal fluid

Answer 375

C. Genitourinary tract

Question 376

Propionobacterium acnes is most often associated with:
A. Food poisoning
B. Post-antibiotic diarrhea
C. Tooth decay
D. Blood culture contamination

Answer 376

D. Blood culture contamination

Question 377

A patient has a suspected diagnosis of subacute bacterial endocarditis. His blood cultures grow non-spore-forming pleomorphic gram-positive bacilli only in the anaerobic bottle. What test(s) will give a presumptive identification of this microorganism?
A. Beta-hemolysis and oxidase
B. Catalase and spot indole
C. Esculin hydrolysis
D. Hydrolysis of gelatin

Answer 377

B. Catalase and spot indole

Question 378

Which feature distinguishes Erysipelothrix rhusiopathiae from other clinically significant non-spore-forming, gram-positive, facultatively anaerobic bacilli?
A. “Tumbling” motility
B. More pronounced motility at 25ºC than 37ºC
C. Beta-hemolysis
D. H2S production

Answer 378

D. H2S production

Question 379

A Campylobacter species isolated from a stool culture gives the following biochemical reactions:
* Nalidixic acid: susceptible
* Cephalothin: resistant
* Oxidase: positive
* Catalase: positive
* Hippurate hydrolysis: positive
This biochemical profile is consistent with:
A. Campylobacter fetus
B. Campylobacter jejuni
C. Campylobacter coli
D. Campylobacter laridis

Answer 379

B. Campylobacter jejuni

Question 380

A specimen was collected for therapeutic drug monitoring (TDM) in a red top evacuated tube. The appropriate course of action is to:
A. Accept the specimen
B. Reject the specimen
C. Warm the specimen
D. Send the specimen to a reference lab

Answer 380

A. Accept the specimen

Question 381

Which of the following immunoglobulins is most efficient at activating complement via the classical pathway?
A. IgG2
B. IgG4
C. IgM
D. IgA

Answer 381

C. IgM

Question 382

A positive ANA with the pattern of anticentromere antibodies is most frequently seen in patients with:
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. CREST syndrome
D. Sjogren syndrome

Answer 382

C. CREST syndrome

Question 383

In the indirect fluorescent anti-nuclear antibody test, a speckled pattern may indicate the presence of antibody to:
A. Histone
B. Sm
C. RNA
D. DNA

Answer 383

B. Sm

Question 384

Autoantibodies in the absence of Sm are found in patients with:
A. Mixed connective tissue disease
B. Systemic lupus erythematosus
C. Crohn disease
D. Multiple myeloma

Answer 384

A. Mixed connective tissue disease

Question 385

Positive rheumatoid factor is generally associated with:
A. Hyperglobulinemia
B. Anemia
C. Decreased erythrocyte sedimentation rate
D. Azotemia

Answer 385

A. Hyperglobulinemia

Question 386

High titers of antimicrosomal antibodies are most often found in:
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Chronic hepatitis
D. Thyroid disease

Answer 386

D. Thyroid disease

Question 387

In chronic active hepatitis, high titers of which of the following antibodies are seen?
A. Antimitochondrial
B. Anti-smooth muscle
C. Anti-DNA
D. Anti-parietal cell

Answer 387

B. Anti-smooth muscle

Question 388

In primary biliary cirrhosis, which of the following antibodies is seen in high titers?
A. Anti-mitochondrial
B. Anti-smooth muscle
C. Anti-DNA
D. Anti-parietal cell

Answer 388

A. Anti-mitochondrial

Question 389

In an anti-nuclear antibody indirect immunofluorescence test, a sample of patient serum shows a positive, speckled pattern. Which would be the most appropriate additional test to perform?
A. Anti-mitochondrial antibody
B. Immunoglobulin quantitation
C. Screen for Sm and RNP antibodies
D. Anti-DNA antibody using Crithidia luciliae

Answer 389

C. Screen for Sm and RNP antibodies

Question 390

Blood is drawn from a patient for serological tests for a viral disease at the time of onset and again 4 weeks later. The results of the tests are considered diagnostic if the:
A. First antibody titer is 2x the second
B. First and second antibody titers are equal
C. First antibody is 4x the second
D. Second antibody titer is at least 4x the first

Answer 390

D. Second antibody titer is at least 4x the first

Question 391

The disappearance of HBsAg and HBeAg, the persistence of anti-HBc, the appearance of anti-HBs, and often of anti-HBe indicate:
A. Early acute HBV hepatitis
B. Early convalescent phase HBV hepatitis
C. Recovery phase of acute HBV hepatitis
D. Carrier state of acute HBV hepatitis

Answer 391

C. Recovery phase of acute HBV hepatitis

Question 392

A bacterial protein used to bind human immunoglobulins is:
A. HAV antibody, IgA type
B. Escherichia coli protein C
C. Staphylococcal protein A
D. HAV antibody, IgG type

Answer 392

C. Staphylococcal protein A

Question 393

Which of the following is the best indicator of an acute infection with the hepatitis A virus?
A. The presence of IgG antibodies to hepatitis A virus
B. The presence of IgM antibodies to hepatitis A virus
C. A sharp decline in the level of IgG antibodies to hepatitis A virus
D. A rise in both IgM and IgG levels of antibody to hepatitis A virus

Answer 393

B. The presence of IgM antibodies to hepatitis A virus

Question 394

The antigen marker most closely associated with transmissibility of HBV infection is:
A. HBs Ag
B. HBe Ag
C. HBc Ag
D. HBV

Answer 394

B. HBe Ag

Question 395

IgM antibodies are frequently hemolytic because of:
A. Their dimeric structure
B. The molecule’s 5 antigen binding sites
C. Their sedimentation coefficient of 7 to 15s
D. Their efficient ability to fix complement

Answer 395

D. Their efficient ability to fix complement

Question 396

Treatment of IgG with papain results in how many fragments from each immunoglobulin molecule?
A. 2
B. 3
C. 4
D. 5

Answer 396

B. 3

Question 397

Which IgG subclass is most efficient at crossing the placenta?
A. IgG1
B. IgG2
C. IgG3
D. IgG4

Answer 397

A. IgG1

Question 398

Patients suffering from Waldenstrom macroglobulinemia demonstrate excessively increased concentrations of which of the following?
A. IgG
B. IgA
C. IgM
D. IgD

Answer 398

C. IgM

Question 399

T cells are incapable of:
A. Collaborating with B cells in antibody responses
B. Secretion of immunoglobulins
C. Secretion of cytokines
D. Producing positive skin tests

Answer 399

B. Secretion of immunoglobulins

Question 400

Tumor markers found in the circulation are most frequently measured by:
A. Immunoassays
B. Thin-layer chromatography
C. High-pressure liquid chromatography
D. Colorimetry

Answer 400

A. Immunoassays

Question 401

A 28-year-old man is seen by a physician because of several months of intermittent low back pain. The patient’s symptoms are suggestive of ankylosing spondylitis. Which of the following laboratory studies would support this diagnosis?
A. A decreased synovial fluid CH50 level
B. Low serum CH50 level
C. Positive HLA-B27 antigen test
D. Rheumatoid factor in the synovial fluid

Answer 401

C. Positive HLA-B27 antigen test

Question 402

HLA-B8 antigen has been associated with which of the following pairs of diseases?
A. Ankylosing spondylitis and myasthenia gravis
B. Celiac disease and akylosing spondylitis
C. Myasthenia gravis and celiac disease
D. Reiter disease and multiple sclerosis

Answer 402

C. Myasthenia gravis and celiac disease

Question 403

Individuals with a _________ are prone to developing severe, recurrent life-threatening infections with encapsulated bacteria such as Streptococcus pneumoniae and may also be subject to immune complex diseases; such complexes can lodge in the kidney and result in glomerulonephritis:
A. C1 deficiency
B. C2 deficiency
C. C3 deficiency
D. C5 deficiency

Answer 403

C. C3 deficiency

Question 404

Discovery of genetic principles underlying the generation of antibodies with different specificities:
A. Gerald Edelman
B. Cesar Milstein
C. Susumu Tonegawa
D. Louis Pasteur

Answer 404

C. Susumu Tonegawa

Question 405

The biochemical tests performed on a gram-positive bacillus were consistent with those of Corynebacterium diphtheriae. The MLS should now:
A. Perform a spore stain of the colonies
B. Determine if the isolate is toxigenic by performingan Elek test
C. Perform an agglutination test to confirm theorganism’s identity
D. Subculture the organism to Hektoen enteric medium and examine for black colonies

Answer 405

B. Determine if the isolate is toxigenic by performingan Elek test

Question 406

Production of exotoxin A, which kills host cells by inhibiting protein synthesis and production of several proteolytic enzymes and hemolysins that destroy cells and tissue are factors that contribute to pathogenicity of which of the following organisms?
A. Pseudomonas aeruginosa
B. Burkholderia cepacia
C. Ralstonia pickettii
D. Burkholderia mallei

Answer 406

A. Pseudomonas aeruginosa

Question 407

Father of Immunology: (Stevens, Turgeon)
A. Edward Jenner
B. Louis Pasteur
C. Ellie Metchnikoff
D. Susumu Tonegawa

Answer 407

B. Louis Pasteur

Question 408

The appearance of Koplik spots in the oral mucosa of patients is characteristic of infection with what viral agent?
A. Hepatitis
B. Measles
C. Rabies
D. Smallpox

Answer 408

B. Measles

Question 409

Kaposi sarcoma is associated with infection by:
A. Adenovirus
B. Cytomegalovirus
C. Hepatitis E virus
D. Human herpes virus 8

Answer 409

D. Human herpes virus 8

Question 410

The type of cell culture that best supports the growth of cytomegalovirus is:
A. HeLa cells
B. HEp-2 cells
C. Human fibroblast cells
D. Primary monkey kidney (PMK) cells

Answer 410

C. Human fibroblast cells

Question 411

An example of a virus associated with latent infections is:
A. Influenza
B. Rotavirus
C. Rubella
D. Varicella-zoster

Answer 411

D. Varicella-zoster

Question 412

Which of the following opportunistic diseases is NOT closely associated with acquired immune deficiency syndrome?
A. Cryptococcosis
B. Cryptosporidiosis
C. Malaria
D. Mycobacteriosis

Answer 412

C. Malaria

Question 413

An 8-week-old infant was admitted to the hospital with symptoms of low birth weight, jaundice, and neurologic defects. Intranuclear inclusions were found in epithelial cells from the urine. The most likely diagnosis in this case would be infection by:
A. Cytomegalovirus
B. Epstein-Barrvirus
C. Herpes simplex virus
D. Rubella virus

Answer 413

A. Cytomegalovirus

Question 414

Which organism fails to grow on artificial media or in cell cultures?
A. Chlamydia trachomatis
B. Neisseria gonorrhoeae
C. Treponema pallidum
D. Herpes simplex virus

Answer 414

C. Treponema pallidum

Question 415

A cell culture line used for the recovery of Chlamydia trachomatis from clinical specimens is:
A. HeLa cells
B. Hep-2
C. BHK-21
D. McCoy

Answer 415

D. McCoy

Question 416

Rickettsiae infecting man multiply preferentially within which of the following cells?
A. Reticuloendothelial
B. Hepatic
C. Renal tubule
D. Endothelial

Answer 416

D. Endothelial

Question 417

Which hepatitis B marker is the best indicator of early acute infection?
A. HBs Ag
B. HBe Ag
C. Anti-HBc
D. Anti-HBs

Answer 417

A. HBs Ag

Question 418

Which is the FIRST ANTIBODY detected in serum after infection with hepatitis B virus (HBV)?
A. Anti-HBs
B. Anti-HBc IgM
C. Anti-HBe
D. All are detectable at the same time

Answer 418

B. Anti-HBc IgM

Question 419

Which hepatitis antibody confers immunity against reinfection with hepatitis B virus?
A. Anti-HBc IgM
B. Anti-HBc IgG
C. Anti-HBe
D. Anti-HBs

Answer 419

D. Anti-HBs

Question 420

John comes in to donate a unit of whole blood at the collection center of the community blood supplier. The EIA screen is reactive for anti-HIV-1/2. The test is repeated in duplicate and is nonreactive. John is:
A. Cleared for donation
B. Deferred for 6 months
C. Status is dependent on confirmatory test
D. Deferred for 12 months

Answer 420

A. Cleared for donation

Question 421

Interpret the following results for HIV infection.
* ELISA: positive
* Repeat ELISA: negative
* Western blot: no bands
A. Positive for HIV
B. Negative for HIV
C. Indeterminate
D. Further testing needed

Answer 421

B. Negative for HIV

Question 422

What is the main difficulty associated with the development of an HIV vaccine?
A. The virus has been difficult to culture; antigen extraction and concentration are extremely laborious
B. Human trials cannot be performed
C. Different strains of the virus are genetically diverse
D. Anti-idiotype antibodies cannot be developed

Answer 422

C. Different strains of the virus are genetically diverse

Question 423

A patient has been diagnosed as having amebiasis but continues to be asymptomatic. The physician has asked for an explanation and recommendations regarding follow-up. Suggestions should include:
A. Consideration of Entamoeba histolytica versus Entamoeba dispar
B. A request for an additional three stools for culture
C. Initiating therapy, regardless of the patient’s asymptomatic status
D. Performance of barium x-ray studies

Answer 423

A. Consideration of Entamoeba histolytica versus Entamoeba dispar

Question 424

A patient is being seen in the emergency department for a low-grade fever, headache, and general malaise after returning from Africa on a photographic safari. The physician has requested blood for malaria; the laboratory would like to have patient information regarding:
A. Specific travel history and body temperature every 4 hours
B. Liver function tests and prophylactic medication history
C. Transfusion history and body temperature every 4 hours
D. Prophylactic medication history and specific travel history

Answer 424

D. Prophylactic medication history and specific travel history

Question 425

A nursing student working in the emergency department accidentally stuck herself with a needle after removing it from an intravenous set taken from a suspected drug user. The best course of action, after reporting the incident to her supervisor, is to:
A. Test the student for HIV virus if flu-like symptoms develop in 2–4 weeks
B. Immediately test the patient and the student for HIV using an EIA or ELISA test
C. Perform a Western blot assay on the student’s serum
D. Draw blood from the student only and freeze it for further testing

Answer 425

B. Immediately test the patient and the student for HIV using an EIA or ELISA test

Question 426

A sputum specimen from an 89-year-old male patient with suspected bacterial pneumonia grew a predominance of gram-positive cocci displaying alpha-hemolysis on 5% sheep blood agar. The colonies appeared donut shaped and mucoidy and tested negative for catalase. The most appropriate tests for a final identification are:
A. Coagulase, glucose fermentation, lysostaphin
B. Penicillin, bacitracin, CAMP
C. Optochin, bile solubility, PYR
D. Bile esculin, hippurate hydrolysis

Answer 426

C. Optochin, bile solubility, PYR

Question 427

An isolate recovered from a vaginal culture obtained from a 25-year-old female patient who is 8 months pregnant is shown to be a gram-positive cocci, catalase negative, and β-hemolytic on blood agar. Which tests are needed for further identification?
A. Optochin, bile solubility, PYR
B. Bacitracin, CAMP, PYR
C. Methicillin, PYR, trehalose
D. Coagulase, glucose, PYR

Answer 427

B. Bacitracin, CAMP, PYR

Question 428

A 1-month-old infant underwent a spinal tap to rule out bacterial meningitis. The CSF was cloudy, and the smear showed many pus cells and short gram-positive rods. After 18 hours, many colonies appeared on blood agar that resembledStreptococcus spp. or L. monocytogenes. Which of the following preliminary tests should be performed on the colonies to best differentiate L. monocytogenes from Streptococcus spp.?
A. Hanging-drop motility (25°C) and catalase
B. PYR and bacitracin
C. Oxidase and glucose
D. Coagulase and catalase

Answer 428

A. Hanging-drop motility (25°C) and catalase

Question 429

Which mycobacterium of the M. tuberculosis complex fails to grow in culture and has a characteristic “croissant-like” morphology in stained smears?
A. M. africanum
B. M. microti
C. M. bovis
D. M. leprae

Answer 429

B. M. microti

Question 430

Which mycobacterium is associated with Crohn’s disease?
A. M. marinum
B. M. paratuberculosis
C. M. avium
D. M. gordonae

Answer 430

B. M. paratuberculosis

Question 431

Growth inhibition by thiophene-2-carboxylic hydrazide (T2H) is used to differentiate M. tuberculosis from which other Mycobacterium specie?
A. M. bovis
B. M. avium–intracellulare complex
C. M. kansasii
D. M. marinum

Answer 431

A. M. bovis

Question 432

Which mechanism is responsible for botulism in infants caused by Clostridium botulinum?
A. Ingestion of spores in food or liquid
B. Ingestion of preformed toxin in food
C. Virulence of the organism
D. Lipase activity of the organism

Answer 432

A. Ingestion of spores in food or liquid

Question 433

The classic form of foodborne botulism is characterized by the ingestion of:
A. Spores in food
B. Preformed toxin in food
C. Toxin H
D. All of these options

Answer 433

B. Preformed toxin in food

Question 434

A gram-positive spore-forming bacillus growing on sheep-blood agar anaerobically produces a double zone of β-hemolysis and is positive for lecithinase. What is the presumptive identification?
A. Bacteroides ureolyticus
B. Bacteroides fragilis
C. Clostridium perfringens
D. Clostridium difficile

Answer 434

C. Clostridium perfringens

Question 435

Which of the following is the most sensitive test to detect congenital syphilis?
A. VDRL
B. RPR
C. Microhemagglutinin test for T. pallidum (MHA-TP)
D. Polymerase chain reaction (PCR)

Answer 435

D. Polymerase chain reaction (PCR)

Question 436

A newborn is to be tested for a vertically transmitted HIV infection. Which of the following tests is most useful?
A. HIV PCR
B. CD4 count
C. Rapid HIV antibody test
D. HIV IgM antibody test

Answer 436

A. HIV PCR

Question 437

Inoculum size for DISK DIFFUSION susceptibility testing:
A. 1 x 10^4 CFU/mL
B. 1.5 x 10^5 CFU/mL
C. 1.5 x 10^8 CFU/mL
D. 5 x 10^5 CFU/mL

Answer 437

C. 1.5 x 10^8 CFU/mL

Question 438

Inoculum size for AGAR DILUTION susceptibility testing:
A. 1 x 10^4 CFU/spot
B. 1.5 x 10^5 CFU/spot
C. 1.5 x 10^8 CFU/spot
D. 5 x 10^5 CFU/spot

Answer 438

A. 1 x 10^4 CFU/spot

Question 439

Inoculum size for BROTH DILUTION susceptibility testing:
A. 1 x 10^4 CFU/mL
B. 1.5 x 10^5 CFU/mL
C. 1.5 x 10^8 CFU/mL
D. 5 x 10^5 CFU/mL

Answer 439

D. 5 x 10^5 CFU/mL

Question 440

Most common cause of ASEPTIC MENINGITIS, an inflammation of the brain parenchyma:
A. Arenavirus
B. Cytomegalovirus
C. Enterovirus
D. Herpes simplex virus 2

Answer 440

C. Enterovirus

Question 441

Subacute sclerosing panencephalitis (SSPE) is a progressive, disabling, and deadly brain disorder related to ______ infection.
A. Chickenpox (varicella)
B. Smallpox (variola major)
C. German measles (rubella)
D. Measles (rubeola)

Answer 441

D. Measles (rubeola)

Question 442

An immunocompromised patient was admitted to the hospital with a diagnosis of HEMORRHAGIC CYSTITIS. Which combination of virus and specimen would be most appropriate to diagnose a viral cause of this disorder?
A. BK virus—urine
B. Human papilloma virus—skin
C. Hepatitis B virus—serum
D. Epstein–Barr virus—serum

Answer 442

A. BK virus—urine

Question 443

JC Virus:
A. Hemorrhagic cystitis
B. Progressive multifocal leukoencaphalopathy
C. Keratoconjunctivitis
D. Lymphocytic choriomeningitis

Answer 443

B. Progressive multifocal leukoencaphalopathy

Question 444

BK Virus:
A. Hemorrhagic cystitis
B. Progressive multifocal leukoencaphalopathy
C. Keratoconjunctivitis
D. Lymphocytic choriomeningitis

Answer 444

A. Hemorrhagic cystitis

Question 445

It causes alveolar hydatid disease which is the most lethal of all helminthic diseases:
A. Taenia saginata
B. Taenia solium
C. Echinococcus granulosus
D. Echinococcus multilocularis

Answer 445

D. Echinococcus multilocularis

Question 446

Intermediate host of Echinococcus multilocularis:
A. Dogs
B. Foxes
C. Coyotes
D. Rodents

Answer 446

D. Rodents

Question 447

The drug of choice for treatment of Paragonimus infections is:
A. Metrifonate
B. Praziquantel
C. Bilarcil
D. Niclosamide

Answer 447

B. Praziquantel

Question 448

The drug of choice for treatment of schistosome infections is:
A. Metrifonate
B. Praziquantel
C. Bilarcil
D. Niclosamide

Answer 448

B. Praziquantel

Question 449

In an iodine preparation of feces, an amebic cyst appears to have a BASKET NUCLEUS and a large glycogen mass that stains reddish-brown. The most probable identity of the cyst is:
A. Entamoeba histolytica
B. Iodamoeba butschlii
C. Naegleria fowleri
D. Entamoeba hartmanni

Answer 449

B. Iodamoeba butschlii

Question 450

The only cestode to have an aquatic life cycle:
A. T. saginata
B. T. solium
C. H. nana
D. D. latum

Answer 450

D. D. latum

Question 451

Methods other than packaged microsystems used to identify anaerobes include:
A. Antimicrobial susceptibility testing
B. Gas–liquid chromatography (GLC)
C. Special staining
D. Enzyme immunoassay

Answer 451

B. Gas–liquid chromatography (GLC)

Question 452

Specimen characteristics of an anaerobic infection include:
A. Foul odor, presence of sulfur granules, and green fluorescence
B. Foul odor, presence of metachromatic granules, and green fluorescence
C. Foul odor, sulfur smell, and red fluorescence
D. Foul odor, presence of sulfur granules, and red fluorescence

Answer 452

D. Foul odor, presence of sulfur granules, and red fluorescence

Question 453

Which of the following viruses is predominantly associated with respiratory disease and epidemics of keratoconjunctivitis?
A. Adenovirus
B. Molluscum contagiosum virus
C. Norwalkvirus
D. Rotavirus

Answer 453

A. Adenovirus

Question 454

Microscopically, numerous smooth, thin-walled, club-shaped, multiseptate (2 to 4 μm) macroconidia are seen. They are rounded at the tip and are borne singly on a conidiophore or in groups of two or three. MICROCONIDIA ARE ABSENT, spiral hyphae are rare, and chlamydoconidia are usually numerous.
A. Epidermophyton floccosum
B. Microsporum canis
C. Trichophyton mentagrophytes
D. Trichophyton rubrum

Answer 454

A. Epidermophyton floccosum

Question 455

Fluorescence on Wood’s lamp, growth in rice medium:
A. Microsporum canis
B. Microsporum gypseum
C. Microsporum audouinii
D. Epidermophyton floccosum

Answer 455

A. Microsporum canis

Question 456

Fluorescence on Wood’s lamp, no growth in rice medium:
A. Microsporum canis
B. Microsporum gypseum
C. Microsporum audouinii
D. Epidermophyton floccosum

Answer 456

C. Microsporum audouinii

Question 457

A flexible calcium alginate nasopharyngeal swab is the collection device of choice for recovery of which organism from the nasopharynx?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Corynebacterium diphtheriae
D. Bacteroides fragilis

Answer 457

C. Corynebacterium diphtheriae

Question 458

Deoxycholate agar (DCA) is useful for the isolation of:
A. Enterobacteriaceae
B. Enterococcus spp.
C. Staphylococcus spp.
D. Neisseria spp.

Answer 458

A. Enterobacteriaceae

Question 459

The most sensitive method for the detection of β-lactamase in bacteria is by the use of:
A. Chromogenic cephalosporin
B. Penicillin
C. Oxidase
D. Chloramphenicol acetyltransferase

Answer 459

A. Chromogenic cephalosporin

Question 460

A gram-negative rod is recovered from a catheterized urine sample from a nursing home patient. The lactose-negative isolate tested positive for indole, urease, ornithine decarboxylase, and phenylalanine deaminase and negative for H2S. The most probable identification is:
A. Edwardsiella spp.
B. Morganella spp.
C. Ewingella spp.
D. Shigella spp.

Answer 460

B. Morganella spp.

Question 461

The most noted differences between P. aeruginosa and Stenotrophomonas maltophilia are:
A. Oxidase, catalase, and TSI
B. Oxidase, catalase, and ONPG
C. Oxidase, 42°C growth, and polar tuft of flagella
D. Catalase, TSI, and pigment

Answer 461

C. Oxidase, 42°C growth, and polar tuft of flagella

Question 462

Which biochemical tests are needed to differentiate Burkholderia cepacia from S. maltophilia?
A. Pigment on blood agar, oxidase, DNase
B. Pigment on MacConkey agar, flagellar stain,motility
C. Glucose, maltose, lysine decarboxylase
D. TSI, motility, oxidase

Answer 462

A. Pigment on blood agar, oxidase, DNase

Question 463

Alcaligenes faecalis (formerly A. odorans) is distinguished from Bordetella bronchiseptica with which test?
A. Urease (rapid)
B. Oxidase
C. Growth on MacConkey agar
D. Motility

Answer 463

A. Urease (rapid)

Question 464

Cetrimide agar is used as a selective isolation agar for which organism?
A. Acinetobacter spp.
B. Pseudomonas aeruginosa
C. Moraxella spp.
D. Stenotrophomonas maltophilia

Answer 464

B. Pseudomonas aeruginosa

Question 465

A 15-year-old female complained of a severe eye irritation after removing her soft-contact lenses. A swab of the infected right eye was obtained by an ophthalmologist, who ordered a culture and sensitivity test. The culture was plated on blood agar and MacConkey agar. At 24 hours, growth of a gram-negative rod that tested positive for cytochrome oxidase was noted. The Mueller–Hinton sensitivity plate showed a bluish-green “lawn” of growth that proved highly resistant to most of the antibiotics tested except amikacin, tobramycin, and ciprofloxacin. What is the most likely identification?
A. Burkholderia cepacia
B. Pseudomonas aeruginosa
C. Stenotrophomonas maltophilia
D. Acinetobacter baumannii

Answer 465

B. Pseudomonas aeruginosa

Question 466

Smooth gray colonies showing no hemolysis are recovered from an infected cat scratch on blood and chocolate agar but fail to grow on MacConkey agar. The organisms are gram-negative pleomorphic rods that are both catalase and oxidase positiveand strongly indole positive. The most likely organism is:
A. Capnocytophaga spp.
B. Pasteurella spp.
C. Proteus spp.
D. Pseudomonas spp.

Answer 466

B. Pasteurella spp.

Question 467

A gram-positive coccus recovered from a wound ulcer from a 31-year-old diabetic patient showed pale yellow, creamy, β-hemolytic colonies on blood agar. Given the following test results, what is the most likely identification?
* Catalase = +
* Glucose OF: positive open tube, negative sealed tube
* Mannitol salt = Neg
* Slide coagulase = Neg

A. Staphylococcus aureus
B. Staphylococcus epidermidis
C. Micrococcus spp.
D. Streptococcus spp.

Answer 467

C. Micrococcus spp.

Question 468

Not considered normal flora, presence in specimens is almost always considered clinically significant:
A. Streptococcus agalactiae
B. Streptococcus pyogenes
C. Enterococcus spp.
D. Viridans streptococci

Answer 468

B. Streptococcus pyogenes

Question 469

Unopened, sliced BACON, packaged in material somewhat highly resistant to oxygen permeability, is spoiled mostly by
A. Lactobacilli
B. Micrococci
C. Fecal Streptococci
D. Molds

Answer 469

A. Lactobacilli

Question 470

Identification of Clostridium tetani is based upon:
A. Gram stain of the wound site
B. Anaerobic culture of the wound site
C. Blood culture results
D. Clinical findings

Answer 470

D. Clinical findings

Question 471

Which gram-negative bacilli produce black pigment and brick red fluorescence when exposed to an ultraviolet light source?
A. Porphyromonas spp. and Prevotella spp.
B. Fusobacterium spp. and Actinomyces spp.
C. Bacteroides spp. and Fusobacterium spp.
D. All of these options

Answer 471

A. Porphyromonas spp. and Prevotella spp.

Question 472

Which of the following is the best technique to identify Dientamoeba fragilis in stool?
A. Formalin concentrate
B. Trichrome-stained smear
C. Modified acid-fast–stained smear
D. Giemsa’s stain

Answer 472

B. Trichrome-stained smear

Question 473

Small protozoa that have been missed on wet mounts or concentration methods are often detected with:
A. India ink
B. Iodine
C. Giemsa stain
D. Trichrome stain

Answer 473

D. Trichrome stain

Question 474

Which of the following genera contain the organisms responsible for the disease scabies caused by the itch mite?
A. Sarcoptes spp.
B. Pediculus spp.
C. Ornithodorus spp.
D. Dermatophagoides spp.

Answer 474

A. Sarcoptes spp.

Question 475

AUTOFLUORESCENCE requires no stain and is recommended for the identification of:
A. Entamoeba histolytica cysts
B. Toxoplasma gondii tachyzoites
C. Dientamoeba fragilis trophozoites
D. Cyclospora cayetanensis oocysts

Answer 475

D. Cyclospora cayetanensis oocysts

Question 476

Top to bottom Layers obtained in FECT:
A. Debris/fats, ether, formalin, sediment
B. Ether, debris/fats, formalin, sediment
C. Ether, formalin, debris/fats, sediment
D. Formalin, ether, debris/fats, sediment

Answer 476

B. Ether, debris/fats, formalin, sediment

Question 477

Large, usually multiseptate and club-shaped or spindle-shaped spores are called which of the following?
A. Microconidia
B. Macroconidia
C. Conidiophores
D. Phialides

Answer 477

B. Macroconidia

Question 478

A patient with a Wood’s lamp–positive, dermatophytic infection has a skin scraping taken for culture. The organism grows on SDA agar with a light-tan front and salmon-colored reverse. Microscopically the organism produces rare distorted macroconidia and rare microconidia. Additionally, there was no growth on sterile rice media. What is the most likely organism?
A. Microsporum canis
B. Microsporum gypseum
C. Microsporum audouinii
D. Epidermophyton floccosum

Answer 478

C. Microsporum audouinii

Question 479

Which of the following is a key characteristic of Coccidioides immitis?
A. Has a higher dissemination rate in white females
B. Is endemic in the northeastern United States
C. Produces endosporulating spherules in tissue
D. Forms foot cells

Answer 479

C. Produces endosporulating spherules in tissue

Question 480

A landscaper noticed a hard, unmovable lump under the skin of his index finger but decided to ignore it. A month later, the lump ulcerated to present a necrotic appearance, and two more lesions developed further up the wrist and forearm.
* A histologic stain of material from deep in the lesions showed elongated yeast cells resembling cigars.

What disease is suspected?

A. Mycetoma
B. Sporotrichosis
C. Chromoblastomycosis
D. Blastomycosis

Answer 480

B. Sporotrichosis

Question 481

Trophozoite forms of amoebae are found in what type of stool specimen?
A. Formed
B. Loose
C. Soft
D. Watery

Answer 481

D. Watery

Question 482

Ova recovered from the stool are routinely used to diagnose infections caused by all of the following except?
A. Necator americanus
B. Ascaris lubricoides
C. Trichuris trichiura
D. Strongyloides stercoralis

Answer 482

D. Strongyloides stercoralis

Question 483

The test of choice and most sensitive assay for use with CSF to diagnose aseptic meningitis caused by enterovirus is which of the following?
A. Cell culture
B. PCR
C. Antigenemia immunoassay
D. Shell vial assay

Answer 483

B. PCR

Question 484

Which of the following is the specimen of choice for detecting rotavirus?
A. Throat swab
B. Urine sample
C. Bronchoalveolar wash
D. Feces sample

Answer 484

D. Feces sample

Question 485

Necator americanus rhabditiform larvae can be differentiated from Strongyloides stercoralis rhabditiform larvae by:
A. Length of the notched tail
B. Length of the head region
C. Segmentation
D. Size of the genital primordium

Answer 485

D. Size of the genital primordium

Question 486

The only known human tapeworm with an operculum is:
A. Diphyllobothrium latum
B. Hymenolepis nana
C. Giardia lamblia
D. Schistosoma haematobium

Answer 486

A. Diphyllobothrium latum

Question 487

Container for stool culture:
A. Stuart’s medium
B. Amies medium
C. Sterile, screw capped container
D. Clean, leakproof container

Answer 487

D. Clean, leakproof container

Question 488

A gram-negative diplococcus isolated from a patient’s CSF specimen gives the following results:
Additional characteristics of this organism include:
Chocolate agar: Growth
SBA: Growth
Oxidase: Positive

CTA test:
* Glucose, yellow
* Maltose, yellow
* Lactose, red
* Sucrose, red

This organism is most likely which of the following?
A. N. meningitidis
B. N. gonorrhoeae
C. N. lactamica
D. M. catarrhalis

Answer 488

A. N. meningitidis

Question 489

The most critical step in obtaining accurate Gram stain results is the application of which of the following?
A. Safranin
B. Crystal violet
C. Gram’s iodine
D. Acetone/ethanol

Answer 489

D. Acetone/ethanol

Question 490

______ protect from viral infection by recognizing and destroying infected cells and ______ protect us indirectly by producing cytokines to stimulate B cells.
A. CD4+ cytotoxic T lymphocytes; CD8+ T helper lymphocytes
B. CD8+ cytotoxic T lymphocytes; CD4+ T helper lymphocytes
C. NK cells; CD8 + T helper lymphocytes
D. NK cells; CD4 + cytotoxic T lymphocytes

Answer 490

B. CD8+ cytotoxic T lymphocytes; CD4+ T helper lymphocytes

Question 491

Features used in identifying Cryptococcus neoformans should include which of the following?
A. Capsule formation, mucoid, creamy-white to yellow colonies, urea positive
B. No capsule formation, produces mycelial forms, urea positive
C. Capsule formation, mucoid, creamy-white to yellow colonies, urea negative
D. No capsule formation, budding yeast cells, mucoid, creamy-white colonies, partially acid-fast

Answer 491

A. Capsule formation, mucoid, creamy-white to yellow colonies, urea positive

Question 492

Most commonly encountered autoimmune hemolytic anemia:
A. Drug-induced AIHA
B. Cold AIHA
C. Warm AIHA
D. Mixed-type AIHA

Answer 492

C. Warm AIHA

Question 493

The L-pyrolidonyl-b-naphthylamide (PYR) hydrolysis test is a presumptive test for which of the following streptococci?
A. Groups A and B
B. Streptococcus pneumoniae and group C
C. Group A and Enterococcus
D. Group A and Streptococcus bovis

Answer 493

C. Group A and Enterococcus

Question 494

Adult location of S. japonicum:
A. Veins surrounding the bladder
B. Venules of the small intestines
C. Venules of large intestines
D. None of these

Answer 494

B. Venules of the small intestines

Question 495

Adult location of S. mansoni:
A. Veins surrounding the bladder
B. Venules of the small intestines
C. Venules of large intestines
D. None of these

Answer 495

C. Venules of large intestines

Question 496

Adult location of S. haematobium:
A. Veins surrounding the bladder
B. Venules of the small intestines
C. Venules of large intestines
D. None of these

Answer 496

A. Veins surrounding the bladder

Question 497

It resembles egg of S. haematobium, but acid-fast positive:
A. Schistosoma japonicum
B. Schistosoma mansoni
C. Schistosoma intercalatum
D. Schistosoma mekongi

Answer 497

C. Schistosoma intercalatum

Question 498

Babesia is an organism that has been implicated in disease from both splenectomized and nonsplenectomized patients. Morphologically, the parasites resemble:
A. Plasmodium falciparum rings
B. Leishmania donovani amastigotes
C. Trypanosoma cruzi trypomastigotes
D. Plasmodium vivax developing rings
E. Trypanosoma brucei gambiense trypomastigotes

Answer 498

A. Plasmodium falciparum rings

Question 499

Plasmodium vivax and Plasmodium ovale are similar because they:
A. Exhibit Schüffner’s dots and have a true relapse in the life cycle
B. Have no malarial pigment and multiple rings
C. Commonly have appliqué forms in the red cells
D. Have true stippling, do not have a relapse stage, and infect old red cells
E. Have a 72-hour periodicity cycle in the RBCs

Answer 499

A. Exhibit Schüffner’s dots and have a true relapse in the life cycle

Question 500

Eye infections with Acanthamoeba spp. have most commonly been traced to:
A. Use of soft contact lenses
B. Use of hard contact lenses
C. Use of contaminated lens care solutions
D. Failure to remove lenses while swimming
E. Dust in the eyes

Answer 500

C. Use of contaminated lens care solutions

Question 501

Which of the following roundworms is capable of autoinfection, hyperinfection, and a heavy worm burden with characteristic larval migration required in the life cycle?
A. Ancylostoma duodenale
B. Enterobius vermicularis
C. Strongyloides stercoralis
D. Ascaris lumbricoides

Answer 501

C. Strongyloides stercoralis

Question 502

Which tapeworm cannot be identified to the species level based on its egg morphology; instead, proglottids must be examined?
A. Diphyllobothrium
B. Dipylidium
C. Hymenolepis
D. Taenia

Answer 502

D. Taenia

Question 503

Infection with Clonorchis or Opisthorchis may result from eating raw or undercooked:
A. Aquatic vegetation
B. Crabs
C. Crayfish
D. Freshwater fish

Answer 503

D. Freshwater fish

Question 504

Most of the pathology associated with parasitic infections results from which of the following?
A.Symbiotic relationships with the host
B.Elaborate parasitic life cycles
C.Immune response to the offending organism
D.Innate defense mechanisms of the host

Answer 504

C.Immune response to the offending organism

Question 505

The chronic nature of parasitic infections is caused by the host’s
A.Inability to eliminate the infective agent
B.Type I hypersensitivity response to the infection
C.Ability to form a granuloma around the parasite
D.Tendency to form circulating immune complexes

Answer 505

A.Inability to eliminate the infective agent

Question 506

Infective stage is the SHEATHED FILARIFORM LARVA:
A. Strongyloides stercoralis
B. Ancylostoma duodenale, Necator americanus
C. Ascaris lumbricoides
D. Enterobius vermicularis

Answer 506

B. Ancylostoma duodenale, Necator americanus

Question 507

Infective stage is the UNSHEATHED FILARIFORM LARVA:
A. Strongyloides stercoralis
B. Ancylostoma duodenale, Necator americanus
C. Ascaris lumbricoides
D. Enterobius vermicularis

Answer 507

A. Strongyloides stercoralis

Question 508

When undercooked meat is digested in the stomach, the larvae are resistant to the gastric pH and pass to the intestine, where they invade the mucosa:
A. Ancylostoma duodenale
B. Ascaris lumbricoides
C. Dracunculus medinesis
D. Trichinella spiralis

Answer 508

D. Trichinella spiralis

Question 509

Symptoms and signs mimic those of TUBERCULOSIS, and should always be suspected in patients with tuberculosis who are non-responsive to treatment:
A. Ascaris lumbricoides
B. Necator americanus
C. Strongyloides stercoralis
D. Paragonimus westermani

Answer 509

D. Paragonimus westermani

Question 510

The worm has a characteristic, thick cuticle and a large uterus that fills the body cavity and contains rhabditoid larvae:
A. Ascaris lumbricoides
B. Enterobius vermicularis
C. Ancylostoma duodenale
D. Dracunculus medinensis

Answer 510

D. Dracunculus medinensis

Question 511

Which of the following are appropriate Ascaris lumbricoides prevention and control strategies?
A. Proper water treatment
B. Appropriate food handling
C. Use of insect repellent
D. Proper sanitation practices

Answer 511

D. Proper sanitation practices

Question 512

This organism is associated with PRIMARY AMOEBIC MENINGOENCEPHALITIS (PAM):
A. Naegleria fowleri
B. Acanthamoeba sp.
C. Entamoeba histolytica
D. Giardia lamblia

Answer 512

A. Naegleria fowleri

Question 513

This organism is associated with GRANULOMATOUS AMEBIC ENCEPHALITIS (GAE):
A. Entamoeba histolytica
B. Dientamoeba fragilis
C. Naegleria fowleri
D. Acanthamoeba sp.

Answer 513

D. Acanthamoeba sp.

Question 514

Individuals become infected with G. intestinalis (G. lamblia) by which of the following?
A. Swimming in contaminated water
B. Ingesting contaminated food or drink
C. Inhalation of infective cysts
D. Walking barefoot on contaminated soil

Answer 514

B. Ingesting contaminated food or drink

Question 515

One of the following protozoan organisms has been implicated in waterborne and foodborne outbreaks. The suspect organism is:
A. Pentatrichomonas hominis
B. Dientamoeba fragilis
C. Giardia lamblia
D. Balantidium coli

Answer 515

C. Giardia lamblia

Question 516

Infection may mimic acute viral enteritis, bacillary dysentery, bacterial or other food poisoning, acute intestinal amebiasis, or “TRAVELER’S DIARRHEA” (ETEC). However, the type of diarrhea plus the lack of blood, mucus, and cellular exudate is consistent with:
A. Amebiasis
B. Ascariasis
C. Balantidiasis
D. Giardiasis

Answer 516

D. Giardiasis

Question 517

Slowly multiplying trophozoite stage of Toxoplasma gondii:
A. Gametocyte
B. Sporozoite
C. Bradyzoite
D. Tachyzoite

Answer 517

C. Bradyzoite

Question 518

Rapidly multiplying trophozoite stage of Toxoplasma gondii:
A. Gametocyte
B. Sporozoite
C. Bradyzoite
D. Tachyzoite

Answer 518

D. Tachyzoite

Question 519

Trichophyton rubrum and T. mentagrophytes may be differentiated by the:
A. Consistently different appearance of their colonies
B. Endothrix hair infection produced by T. rubrum
C. Fluorescence of hairs infected with T. rubrum
D. In vitro hair penetration by T. mentagrophytes

Answer 519

D. In vitro hair penetration by T. mentagrophytes

Question 520

Type of microscope that forms HALO of light around an object:
A. Bright-field
B. Dark-field microscope
C. Polarizing microscope
D. Phase-contrast

Answer 520

D. Phase-contrast

Question 521

Three-dimensional images of high contrast and resolution are obtained, without haloing:
A. Bright-field microscopy
B. Polarizing microscopy
C. Phase-contrast microscopy
D. Interference contrast microscopy

Answer 521

D. Interference contrast microscopy

Question 522

Most common type of microscopy performed in the urinalysis laboratory:
A. Bright-field microscopy
B. Phase-contrast microscopy
C. Polarizing microscopy
D. Interference-contrast microscope

Answer 522

A. Bright-field microscopy

Question 523

Enhances visualization of elements with low refractive indices, such as hyaline casts, mixed cellular casts, mucous threads, and Trichomonas:
A. Bright-field microscopy
B. Phase-contrast microscopy
C. Polarizing microscopy
D. Interference-contrast microscope

Answer 523

B. Phase-contrast microscopy

Question 524

Concentration of SSA in the cold precipitation method:
A. 1% sulfosalicylic acid
B. 3% sulfosalicylic acid
C. 5% sulfosalicylic acid
D. 10% sulfosalicylic acid

Answer 524

B. 3% sulfosalicylic acid

Question 525

Albumin reagent strips utilizing the dye ________ has a higher sensitivity and specificity for albumin:
A. DIDNTB
B. TMB
C. DBDH
D. Tetrabromphenol blue

Answer 525

A. DIDNTB

Question 526

Black color of Argyrol, an antiseptic, disappears with addition of:
A. Copper sulfate
B. Ferric chloride
C. Sodium nitroprusside
D. Trichloroacetic acid

Answer 526

B. Ferric chloride

Question 527

Specimens from patients receiving treatment for urinary tract infections frequently appear:
A. Clear and red
B. Viscous and orange
C. Dilute and pale yellow
D. Cloudy and red

Answer 527

B. Viscous and orange

Question 528

Specimens containing _________ produce a yellow foam when shaken, which could be mistaken for bilirubin.
A. Phenazopyridine (Pyridium)
B. Phenindione
C. Methyldopa
D. Metronidazole (Flagyl)

Answer 528

A. Phenazopyridine (Pyridium)

Question 529

Anticoagulant, orange in alkaline urine, colorless in acid urine.
A. Phenazopyridine (Pyridium)
B. Phenindione
C. Methyldopa
D. Metronidazole (Flagyl)

Answer 529

B. Phenindione

Question 530

Phenol derivatives found in certain intravenous medications produce ______urine on oxidation.
A. Yellow
B. Orange
C. Green
D. Purple

Answer 530

C. Green

Question 531

As a result of the brittle consistency of the cast matrix, they often appear fragmented with jagged ends and have notches in their sides. With supravital stains, these casts stain a homogenous, dark pink.
A. Hyaline
B. Cellular
C. Granular
D. Waxy

Answer 531

D. Waxy

Question 532

Esterases also are present in which parasite?
A. Enterobius
B. Giardia
C. Schistosoma
D. Trichomonas

Answer 532

D. Trichomonas

Question 533

The amount of amniotic fluid increases in quantity throughout pregnancy, reaching a peak of approximately ____ mL during the third trimester, and then gradually decreases prior to delivery.
A. 400 to 800 mL
B. 800 mL to 1,200 mL
C. 1,200 to 1,500 mL
D. 2,000 to 4, 000 mL

Answer 533

B. 800 mL to 1,200 mL

Question 534

Given the following laboratory results, what is the most likely cause for the patient’s condition:

Serum results
* BUN 35 mg/dL
* Creatinine 2 mg/dL
* Uric acid 9.5 mg/dL

Urine macroscopic results
* Glucose negative
* Blood positive
* WBCs negative
* pH 6
* Protein positive
* SSA 2+

Urine microscopic results
* 25 - 50 RBCs/hpf
* 0 - 2 WBCs/hpf
* 2 - 5 RBC casts
* 3 - 5 Hyaline casts
* 0 - 2 granular casts
* Few uric acid crystals

A. Gout
B. Glomerulonephritis
C. Pyelonephritis
D. Urinary tract infection

Answer 534

B. Glomerulonephritis

Question 535

Calibration of centrifuges is customarily performed every ______.
A. Daily
B. Weekly
C. Every 3 months (quarterly)
D. Annually

Answer 535

C. Every 3 months (quarterly)

Question 536

Centrifuges are routinely disinfected on a ___ basis.
A. Daily
B. Weekly
C. Monthly
D. Yearly

Answer 536

B. Weekly

Question 537

The physician is concerned that a pregnant patient may be at risk for delivering prematurely. What would be the best biochemical marker to measure to assess the situation?
A. Inhibin A
B. Alpha1-Fetoprotein
C. Fetal fibronectin
D. Human chorionic gonadotropin

Answer 537

C. Fetal fibronectin

Question 538

Reporting for squamous epithelial cells:
A. Rare, few, moderate or many per hpf
B. Rare, few, moderate or many per lpf
C. Average number per 10 hpf
D. Present, based on laboratory protocol

Answer 538

B. Rare, few, moderate or many per lpf

Question 539

Reporting for transitional cells:
A. Rare, few, moderate or many per hpf
B. Rare, few, moderate or many per lpf
C. Average number per 10 hpf
D. Present, based on laboratory protocol

Answer 539

A. Rare, few, moderate or many per hpf

Question 540

Reporting for RTE cells:
A. Rare, few, moderate or many per hpf
B. Rare, few, moderate or many per lpf
C. Average number per 10 hpf
D. Present, based on laboratory protocol

Answer 540

C. Average number per 10 hpf

Question 541

The presence of _____ increases the OD of the amniotic fluid. Specimens are centrifuged at 2,000 g for 10 minutes and examined using a wavelength of 650 nm.
A. Bilirubin
B. Oxyhemoglobin
C. Lamellar bodies
D. None of these

Answer 541

C. Lamellar bodies

Question 542

Close wound:
A. Abrasion
B. Hematoma
C. Laceration
D. Puncture

Answer 542

B. Hematoma

Question 543

Peak levels of this analyte typically occur around 0800 hours.
A. Bilirubin
B. Cortisol
C. Eosinophil
D. Glucose

Answer 543

B. Cortisol

Question 544

A comatose 27-year-old woman is brought to the emergency room by paramedics, and the strong odor of bitter almonds is present. The differential diagnosis must include the possibility of poisoning by:
A. Ethylene glycol
B. Carbon monoxide
C. Carbon tetrachloride
D. Cyanide
E. Arsenic

Answer 544

D. Cyanide

Question 545

Oocysts of Cryptosporidium spp. can be detected in stool specimens using:
A. Modified Ziehl–Neelsen acid-fast stain
B. Gram stain
C. Methenamine silver stain
D. Trichrome stain

Answer 545

A. Modified Ziehl–Neelsen acid-fast stain

Question 546

Which combination best describes a Gaussian (normal) distribution?
A. Median > mode
B. Mean = median = mode
C. Median > mean
D. Mode > mean

Answer 546

B. Mean = median = mode

Question 547

A tumor marker for the diagnosis of urinary bladder cancer:
A. CA 19-9
B. HER-2/neu
C. Calcitonin
D. NMP

Answer 547

D. NMP

Question 548

Nonmotile, non-spore-forming, obligate aerobe, acid-fast bacillus that often appears beaded or unstained using Gram stain; it is distinguished by its ability to form stable mycolate complexes with arylmethane dyes (carbolfuchsin, auramine, and rhodamine):
A. Streptococcus pneumoniae
B. Neisseria meningitidis
C. Hemophilus influenzae
D. Mycobacterium tuberculosis

Answer 548

D. Mycobacterium tuberculosis

Question 549

Elevated in bronchoalveolar lavage of cigarette smokers, and in cases of bronchopneumonia, toxin exposure, and diffuse alveolar damage:
A. Neutrophils
B. Eosinophils
C. Marcophages
D. Mast cells

Answer 549

A. Neutrophils

Question 550

An elevated urine urobilinogen and a negative test for urine bilirubin may indicated which of the following conditions?
A. Acute hepatic toxicity
B. Biliary obstruction
C. Hemolytic disease
D. Urinary tract infection

Answer 550

C. Hemolytic disease

Question 551

An L/S ratio of 2.7 indicates:
A. Fetal distress
B. Fetal lung maturity
C. Fetal red cell destruction
D. Inadequate fetal pulmonary surfactants

Answer 551

B. Fetal lung maturity

Question 552

Calcium pyrophosphate (pseudogout) in synovial fluid:
1. Needles
2. Rhomboid square, rods
3. Negative birefringence under compensated polarized light
4. Positive birefringence under compensated polarized light
A. 1 and 3
B. 1 and 4
C. 2 and 3
D. 2 and 4

Answer 552

D. 2 and 4

Question 553

Bence Jones protein precipitates at temperatures between ___ , and redissolves at near ___ ° C.
A. Precipitates at 100 to 120C, and redissolves at 60C
B. Precipitates at 10 to 20C, and redissolves at 100C
C. Precipitates at 80 to 100C, and redissolves at 60C
D. Precipitates at 40 to 60C, and redissolves at 100C

Answer 553

D. Precipitates at 40 to 60C, and redissolves at 100C

Question 554

Hoesch reagent consists of:
A. Ehrlich’s reagent in 3M HCl
B. Ehrlich’s reagent in 6M HCl
C. Ehrlich’s reagent in 3M NaOH
D. Ehrlich’s reagent in 6M NaOH

Answer 554

B. Ehrlich’s reagent in 6M HCl

Question 555

Quadrate scolex with 4 suckers; no rostellum or hooklets:
A. D. latum
B. T. saginata
C. T. solium
D. H. diminuta

Answer 555

B. T. saginata

Question 556

Quadrate scolex with 4 suckers; has rostellum and hooklets:
A. D. latum
B. T. saginata
C. T. solium
D. H. diminuta

Answer 556

C. T. solium

Question 557

When encountering a patient with a fistula, the phlebotomist should:
A. Apply the tourniquet below the fistula
B. Use the other arm
C. Collect the blood from the fistula
D. Attach a syringe to the T-tube connector

Answer 557

B. Use the other arm

Question 558

EDTA is used in concentrations of __ of blood.
A. 0.5 mg/1 mL of whole blood
B. 1.5 mg/1 mL of whole blood
C. 2.5 mg/1 mL of whole blood
D. 3.5 mg/1 mL of whole blood

Answer 558

B. 1.5 mg/1 mL of whole blood

Question 559

Sodium citrate in the concentration of a _____ solution has been adopted as the appropriate concentration by the ICSH and the International Society for Thrombosis and Hemostasis for coagulation studies.
A. 1.5%
B. 15%
C. 3.2%
D. 3.8%

Answer 559

C. 3.2%

Question 560

Heparin is added ____ per mL of blood in each test tube.
A. 0.2 mcg per mL
B. 2.0 mcg per mL
C. 0.2 mg per mL
D. 2 mg per mL

Answer 560

C. 0.2 mg per mL

Question 561

When measuring trace metals in blood other than lead, what type of tube should be used?
A. Navy blue top
B. Green top
C. Purple top
D. Red top

Answer 561

A. Navy blue top

Question 562

Which of the ff. makes Mannitol Salt Agar (MSA) selective?
A.Mannitol
B.Phenol red
C.Neutral red
D. Sodium chloride

Answer 562

D. Sodium chloride

Question 563

Stem cells are present in the first few hours after an ovum is fertilized; most versatile type of stem cell:
A. Multipotential stem cells
B. Pluripotential stem cells
C. Totipotential stem cells
D. Any of these

Answer 563

C. Totipotential stem cells

Question 564

Stem cells can develop into any cell type, except they cannot develop into a fetus:
A. Multipotential stem cells
B. Pluripotential stem cells
C. Totipotential stem cells
D. None of these

Answer 564

B. Pluripotential stem cells

Question 565

Stem cells that can be found in adults, but they are limited to specific types of cells to form tissues:
A. Multipotential stem cells
B. Pluripotential stem cells
C. Totipotential stem cells
D. None of these

Answer 565

A. Multipotential stem cells

Question 566

Smallest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome

Answer 566

D. Wiskott-Aldrich syndrome

Question 567

Largest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome

Answer 567

B. Bernard-Soulier syndrome

Question 568

Platelet adhesion defect:
A. Bernard-Soulier syndrome
B. Essential athrombia
C. Afibrinogenemia
D. Glanzmann thrombasthenia

Answer 568

A. Bernard-Soulier syndrome

Question 569

Primary platelet aggregation defect(s):
1. Bernard-Soulier syndrome
2. Essential athrombia
3. Afibrinogenemia
4. Glanzmann thrombasthenia

A. 1 and 3
B. 2 and 4
C. 1, 2 and 3
D. Only 4

Answer 569

B. 2 and 4

Question 570

Upon stimulation, platelets change in shape from discoid to _____, extend pseudopods, undergo internal contraction resulting in centralization of their alpha granules and dense granules, and release the granule contents.
A. Cylindrical
B. Irregular
C. Oval
D. Spherical

Answer 570

D. Spherical

Question 571

RBC with membrane folded over:
A. Aplastic anemia
B. Iron deficiency anemia
C. Hemoglobin C, hemoglobin SC disease
D. Sickle cell anemia, thalassemia

Answer 571

C. Hemoglobin C, hemoglobin SC disease

Question 572

Which hemoglobin contains four gamma chains and has an extremely high affinity for oxygen?
A. Hb H
B. Hb Bart’s
C. Hb Portland
D. Hb Gower 1

Answer 572

B. Hb Bart’s

Question 573

The phosphotungstic acid hematoxylin (PTAH) is useful for demonstrating:
A. Edema fluid
B. Muscle striations
C. Ground substance
D. Reticulin network

Answer 573

B. Muscle striations

Question 574

Warthin-Starry method:
A. Mycobacterium
B. Nocardia
C. Spirochetes
D. None of these

Answer 574

C. Spirochetes

Question 575

What is the most sensitive lipid stain?
A. Oil red O
B. Sudan III
C. Sudan IV
D. Sudan Black B

Answer 575

D. Sudan Black B

Question 576

Frozen sections are stained by hand because:
A. Staining is more accurate
B. Prevent overstaining
C. Faster for one or a few individual sections
D. Predictable colors

Answer 576

C. Faster for one or a few individual sections

Question 577

First step in automated tissue processor:
A. Cold formalin
B. Hot formalin
C. Cold ethanol
D. Hot ethanol

Answer 577

B. Hot formalin

Question 578

The cell selected for chromosome analysis is usually in the ____ stage of cellular division.
A. Prophase
B. Metaphase
C. Telophase
D. Anaphase

Answer 578

B. Metaphase

Question 579

The ideal site of capillary puncture in infants is the medial or lateral plantar surface of the heel, with a puncture no deeper than ____ mm beneath the plantar heel-skin surface.
A. 2.0 mm
B. 2.4 mm
C. 2.6 mm
D. 3.0 mm

Answer 579

A. 2.0 mm

Question 580

Phlebotomy complications including diaphoresis, seizure, pain, and nerve damage:
A. Cardiovascular complications
B. Vascular complications
C. Neurological complications
D. Infections

Answer 580

C. Neurological complications

Question 581

Target INR for pulmonary embolism (PE) treatment:
A. 1.0
B. 2.0
C. 3.0
D. 4.0

Answer 581

C. 3.0

Question 582

Solid tumor counterpart of plasma cell leukemia:
A. Lymphoma well-differentiated
B. Lymphoma, undifferentiated
C. Lymphoma, poorly differentiated
D. Reticulum cell sarcoma
E. Myeloma

Answer 582

E. Myeloma

Question 583

INR range recommended for most indications (e.g., treatment or prophylaxis of deep venous thrombosis [DVT], or prevention of further clotting in patients who have had a myocardial infarction):
A. 1.0 to 1.5
B. 1.5 to 2.0
C. 2.0 to 3.0
D. 2.5 to 3.5

Answer 583

C. 2.0 to 3.0

Question 584

INR recommended for patients with prosthetic heart valves:
A. 1.0 to 1.5
B. 1.5 to 2.0
C. 2.0 to 3.0
D. 2.5 to 3.5

Answer 584

D. 2.5 to 3.5

Question 585

The target INR for pulmonary embolism (PE) treatment is ____ for the duration of anticoagulation.
A. 1.0
B. 2.0
C. 2.5
D. 3.0

Answer 585

D. 3.0

Question 586

Typically the size of a small lymphocyte and has a dark-staining, clumped, nuclear chromatin pattern; the distinctive folded, groove-like chromatin pattern is described as cerebriform.
A. Hairy cell
B. Sezary cell
C. Mott cell
D. Reed-Sternberg cell

Answer 586

B. Sezary cell

Question 587

Maintains cellular energy by generating ATP:
A. Methemoglobin reductase pathway
B. Hexose monophosphate shunt
C. Luebering-Rapaport pathway
D. Embden-Meyerhof pathway

Answer 587

D. Embden-Meyerhof pathway

Question 588

Regulates oxygen affinity of hemoglobin:
A. Methemoglobin reductase pathway
B. Hexose monophosphate shunt
C. Luebering-Rapaport pathway
D. Embden-Meyerhof pathway

Answer 588

C. Luebering-Rapaport pathway

Question 589

Prevents oxidation of heme iron:
A. Methemoglobin reductase pathway
B. Hexose monophosphate shunt
C. Luebering-Rapaport pathway
D. Embden-Meyerhof pathway

Answer 589

A. Methemoglobin reductase pathway

Question 590

Prevents denaturation of globin of the hemoglobin molecule:
A. Methemoglobin reductase pathway
B. Hexose monophosphate shunt
C. Luebering-Rapaport pathway
D. Embden-Meyerhof pathway

Answer 590

B. Hexose monophosphate shunt

Question 591

Most frequently implicated infected body fluid in HIV and HBV exposure in the workplace:
A. Saliva
B. Blood
C. Urine
D. Seminal fluid

Answer 591

B. Blood

Question 592

Solid tumor counterpart of monocytic leukemia:
A. Lymphoma well-differentiated
B. Lymphoma, undifferentiated
C. Lymphoma, poorly differentiated
D. Reticulum cell sarcoma
E. Myeloma

Answer 592

D. Reticulum cell sarcoma

Question 593

The heme portion of the hemoglobin molecule consists of ____ iron (Fe2+) atom and ____ pyrrole rings that are joined to each other.
A. 4 iron atoms, 4 pyrrole rings
B. 1 iron atom, 2 pyrrole rings
C. 1 iron atom, 4 pyrrole rings
D. 4 iron atoms, 4 pyrrole rings

Answer 593

C. 1 iron atom, 4 pyrrole rings

Question 594

Preanalytical (pre-examination) errors, except:
A. Blood specimens collected in the wrong order
B. Incorrect labeling of specimen
C. Improper processing of specimen
D. Wrong assay performed

Answer 594

D. Wrong assay performed

Question 595

Once the metamyelocyte stage has been reached, cells have undergone ______ cell divisions and the proliferative phase comes to an end.
A. 1 or 2 cell divisions
B. 2 or 3 cell divisions
C. 3 or 4 cell divisions
D. 4 or 5 cell divisions

Answer 595

D. 4 or 5 cell divisions

Question 596

Clinical signs and symptoms commonly include low birth weight (<2,500 g), skin hyperpigmentation (café au lait spots), and short stature. Other manifestations can include skeletal disorders (aplasia or hypoplasia of the thumb), renal malformations, microcephaly, hypogonadism, mental retardation, and strabismus.

A. Diamond Blackfan anemia
B. Iron deficiency anemia
C. Fanconi anemia
D. Sideroblastic anemia

Answer 596

C. Fanconi anemia

Question 597

Cardiovascular complications of phlebotomy:
1. Cardiac arrest
2. Hypotension
3. Syncope
4. Shock

A. 1 and 2
B. 1 and 3
C. 1, 2 and 3
D. 1, 2, 3 and 4

Answer 597

D. 1, 2, 3 and 4

Question 598

In general, cytoplasmic color in younger cells:
A. Pink
B. Red
C. Dark blue
D. Light blue

Answer 598

C. Dark blue

Question 599

Aldosterone is involved in the reabsorption of:
A. Potassium
B. Sodium
C. Bicarbonate
D. Hydrogen ion

Answer 599

B. Sodium

Question 600

Refractive index compares the velocity of light in urine to the velocity of light in:
A. Air
B. Oil
C. Saline
D. Water

Answer 600

A. Air